Long-term Follow-up of Living Kidney Donors With Chronic Kidney Disease at 1 Year After Nephrectomy

J. C. Na, J. S. Park, M. G. Yoon, H. H. Lee, Y. E. Yoon, K. H. Huh, Y. S. Kim, W. K. Han

Research output: Contribution to journalArticle

Abstract

Background: Although renal function recovery of living kidney donors has been reported in a number of studies, many patients show poor recovery, and the long-term prognosis of these patients has not been well studied. In this investigation we explored the long-term prognosis of renal function in patients with chronic kidney disease (CKD) at 1 year after nephrectomy. Methods: Patients who underwent donor nephrectomy during the period from March 2006 to April 2014, with a follow-up creatinine study at 1 year postoperatively and more than 3 years of follow-up, were included in the study. Creatinine and estimated glomerular filtration rate (eGFR, using the Modification of Diet in Renal Disease formula) before and after surgery were studied. Age, sex, history of hypertension or diabetes, body mass index, blood pressure, complete blood count, preoperative routine serum chemistry, and urine study results were reviewed. Results: Among 841 patients who had donor nephrectomy, 362 were included in the study. There were 111 patients (30.6%) with eGFR <60 mL/min/1.73 m2 at 1 year postsurgery, and the median follow-up period was 62.8 months (interquartile range [IQR] 42.0–86.3 months). The maximum eGFR after 3-year follow-up was studied, and 48 patients (43.2%) never recovered eGFR to >60 mL/min/1.73 m2. Age, history of hypertension, preoperative eGFR, and eGFR at 1 year were predictive factors at univariate analysis. Multivariate analysis of these factors was studied, and age (52.5 [IQR 47–55.7] vs 47 [IQR 7–53] years, odds ratio [OR] 1.1, 95% confidence interval [CI] 1.02–1.15, P =.007), history of hypertension (16.7% vs 1.6%, OR 10.0, 95% CI 1.09–92.49, P =.042), and eGFR at 1 year (53.9 [IQR 50.3–56.0] vs 57.0 [IQR 54.2–58.4] mL/min/1.73 m2, OR 0.8, 95% CI 0.72–0.92, P =.002) remained as significant risk factors. Conclusion: Of all living donors, 15.7% had CKD after >3 years of follow-up. Close observation is warranted when donors have CKD after 1 year follow-up, as 43.2% fail to recover renal function. Patients who are older, have a history of hypertension, and have low eGFR at 1-year follow-up are especially at risk.

Original languageEnglish
Pages (from-to)1018-1021
Number of pages4
JournalTransplantation Proceedings
Volume50
Issue number4
DOIs
Publication statusPublished - 2018 May

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Living Donors
Nephrectomy
Chronic Renal Insufficiency
Kidney
Hypertension
Odds Ratio
Tissue Donors
Confidence Intervals
Creatinine
Diet Therapy
Blood Cell Count
Recovery of Function
Glomerular Filtration Rate
Body Mass Index
Multivariate Analysis
Observation
Urine
Blood Pressure
Serum

All Science Journal Classification (ASJC) codes

  • Surgery
  • Transplantation

Cite this

Na, J. C. ; Park, J. S. ; Yoon, M. G. ; Lee, H. H. ; Yoon, Y. E. ; Huh, K. H. ; Kim, Y. S. ; Han, W. K. / Long-term Follow-up of Living Kidney Donors With Chronic Kidney Disease at 1 Year After Nephrectomy. In: Transplantation Proceedings. 2018 ; Vol. 50, No. 4. pp. 1018-1021.
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title = "Long-term Follow-up of Living Kidney Donors With Chronic Kidney Disease at 1 Year After Nephrectomy",
abstract = "Background: Although renal function recovery of living kidney donors has been reported in a number of studies, many patients show poor recovery, and the long-term prognosis of these patients has not been well studied. In this investigation we explored the long-term prognosis of renal function in patients with chronic kidney disease (CKD) at 1 year after nephrectomy. Methods: Patients who underwent donor nephrectomy during the period from March 2006 to April 2014, with a follow-up creatinine study at 1 year postoperatively and more than 3 years of follow-up, were included in the study. Creatinine and estimated glomerular filtration rate (eGFR, using the Modification of Diet in Renal Disease formula) before and after surgery were studied. Age, sex, history of hypertension or diabetes, body mass index, blood pressure, complete blood count, preoperative routine serum chemistry, and urine study results were reviewed. Results: Among 841 patients who had donor nephrectomy, 362 were included in the study. There were 111 patients (30.6{\%}) with eGFR <60 mL/min/1.73 m2 at 1 year postsurgery, and the median follow-up period was 62.8 months (interquartile range [IQR] 42.0–86.3 months). The maximum eGFR after 3-year follow-up was studied, and 48 patients (43.2{\%}) never recovered eGFR to >60 mL/min/1.73 m2. Age, history of hypertension, preoperative eGFR, and eGFR at 1 year were predictive factors at univariate analysis. Multivariate analysis of these factors was studied, and age (52.5 [IQR 47–55.7] vs 47 [IQR 7–53] years, odds ratio [OR] 1.1, 95{\%} confidence interval [CI] 1.02–1.15, P =.007), history of hypertension (16.7{\%} vs 1.6{\%}, OR 10.0, 95{\%} CI 1.09–92.49, P =.042), and eGFR at 1 year (53.9 [IQR 50.3–56.0] vs 57.0 [IQR 54.2–58.4] mL/min/1.73 m2, OR 0.8, 95{\%} CI 0.72–0.92, P =.002) remained as significant risk factors. Conclusion: Of all living donors, 15.7{\%} had CKD after >3 years of follow-up. Close observation is warranted when donors have CKD after 1 year follow-up, as 43.2{\%} fail to recover renal function. Patients who are older, have a history of hypertension, and have low eGFR at 1-year follow-up are especially at risk.",
author = "Na, {J. C.} and Park, {J. S.} and Yoon, {M. G.} and Lee, {H. H.} and Yoon, {Y. E.} and Huh, {K. H.} and Kim, {Y. S.} and Han, {W. K.}",
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Long-term Follow-up of Living Kidney Donors With Chronic Kidney Disease at 1 Year After Nephrectomy. / Na, J. C.; Park, J. S.; Yoon, M. G.; Lee, H. H.; Yoon, Y. E.; Huh, K. H.; Kim, Y. S.; Han, W. K.

In: Transplantation Proceedings, Vol. 50, No. 4, 05.2018, p. 1018-1021.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Long-term Follow-up of Living Kidney Donors With Chronic Kidney Disease at 1 Year After Nephrectomy

AU - Na, J. C.

AU - Park, J. S.

AU - Yoon, M. G.

AU - Lee, H. H.

AU - Yoon, Y. E.

AU - Huh, K. H.

AU - Kim, Y. S.

AU - Han, W. K.

PY - 2018/5

Y1 - 2018/5

N2 - Background: Although renal function recovery of living kidney donors has been reported in a number of studies, many patients show poor recovery, and the long-term prognosis of these patients has not been well studied. In this investigation we explored the long-term prognosis of renal function in patients with chronic kidney disease (CKD) at 1 year after nephrectomy. Methods: Patients who underwent donor nephrectomy during the period from March 2006 to April 2014, with a follow-up creatinine study at 1 year postoperatively and more than 3 years of follow-up, were included in the study. Creatinine and estimated glomerular filtration rate (eGFR, using the Modification of Diet in Renal Disease formula) before and after surgery were studied. Age, sex, history of hypertension or diabetes, body mass index, blood pressure, complete blood count, preoperative routine serum chemistry, and urine study results were reviewed. Results: Among 841 patients who had donor nephrectomy, 362 were included in the study. There were 111 patients (30.6%) with eGFR <60 mL/min/1.73 m2 at 1 year postsurgery, and the median follow-up period was 62.8 months (interquartile range [IQR] 42.0–86.3 months). The maximum eGFR after 3-year follow-up was studied, and 48 patients (43.2%) never recovered eGFR to >60 mL/min/1.73 m2. Age, history of hypertension, preoperative eGFR, and eGFR at 1 year were predictive factors at univariate analysis. Multivariate analysis of these factors was studied, and age (52.5 [IQR 47–55.7] vs 47 [IQR 7–53] years, odds ratio [OR] 1.1, 95% confidence interval [CI] 1.02–1.15, P =.007), history of hypertension (16.7% vs 1.6%, OR 10.0, 95% CI 1.09–92.49, P =.042), and eGFR at 1 year (53.9 [IQR 50.3–56.0] vs 57.0 [IQR 54.2–58.4] mL/min/1.73 m2, OR 0.8, 95% CI 0.72–0.92, P =.002) remained as significant risk factors. Conclusion: Of all living donors, 15.7% had CKD after >3 years of follow-up. Close observation is warranted when donors have CKD after 1 year follow-up, as 43.2% fail to recover renal function. Patients who are older, have a history of hypertension, and have low eGFR at 1-year follow-up are especially at risk.

AB - Background: Although renal function recovery of living kidney donors has been reported in a number of studies, many patients show poor recovery, and the long-term prognosis of these patients has not been well studied. In this investigation we explored the long-term prognosis of renal function in patients with chronic kidney disease (CKD) at 1 year after nephrectomy. Methods: Patients who underwent donor nephrectomy during the period from March 2006 to April 2014, with a follow-up creatinine study at 1 year postoperatively and more than 3 years of follow-up, were included in the study. Creatinine and estimated glomerular filtration rate (eGFR, using the Modification of Diet in Renal Disease formula) before and after surgery were studied. Age, sex, history of hypertension or diabetes, body mass index, blood pressure, complete blood count, preoperative routine serum chemistry, and urine study results were reviewed. Results: Among 841 patients who had donor nephrectomy, 362 were included in the study. There were 111 patients (30.6%) with eGFR <60 mL/min/1.73 m2 at 1 year postsurgery, and the median follow-up period was 62.8 months (interquartile range [IQR] 42.0–86.3 months). The maximum eGFR after 3-year follow-up was studied, and 48 patients (43.2%) never recovered eGFR to >60 mL/min/1.73 m2. Age, history of hypertension, preoperative eGFR, and eGFR at 1 year were predictive factors at univariate analysis. Multivariate analysis of these factors was studied, and age (52.5 [IQR 47–55.7] vs 47 [IQR 7–53] years, odds ratio [OR] 1.1, 95% confidence interval [CI] 1.02–1.15, P =.007), history of hypertension (16.7% vs 1.6%, OR 10.0, 95% CI 1.09–92.49, P =.042), and eGFR at 1 year (53.9 [IQR 50.3–56.0] vs 57.0 [IQR 54.2–58.4] mL/min/1.73 m2, OR 0.8, 95% CI 0.72–0.92, P =.002) remained as significant risk factors. Conclusion: Of all living donors, 15.7% had CKD after >3 years of follow-up. Close observation is warranted when donors have CKD after 1 year follow-up, as 43.2% fail to recover renal function. Patients who are older, have a history of hypertension, and have low eGFR at 1-year follow-up are especially at risk.

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