Introduction:
Kidney transplantation has emerged as a viable useful preferable treatment alternative for ESRD patients over last few decades. The use of living donors is more prevalent in some parts of the world. The significance of functional renal reserve(FRR) lies in its predictive value for post donation outcomes. Generally it is done through protein loading using animal protein. For vegetarian live donors, use of animal protein for this assessment poses an ethical, religious or personal dilemma. This present study was conducted to asses the feasibility and safety of vegetarian diet on FRR before kidney donation.
Methods:
A total of 50 live kidney donors (age range 31 to 64 years; mean age 44.84±8.71 years; 74% females) eligible for participation in the study were enrolled in the study and underwent hemodynamic, biochemical and renal function assessment. At enrolment, glomerular filtration rate (GFR) was assessed. All the participants were subjected to renal reserve test (RRT) by administering a vegetarian protein load (as per protocol of the study). Post-protein load GFR was also estimated. Absolute and percentage change in GFR was assessed to estimate the functional renal reserve (FRR). Participants with RFR more than or equal to median value were categorized as good responders while those having RFR below were categorized as poor responders. Clinical and demographic profile of good and poor responders was compared statistically.
Results:
Mean FRR was 8.52±8.15 mL/min/1.73m2. In percentage terms, FRR ranged from -13.04 to 56.52%. There were 2 (4%) patients showing negative FRR. Median % RFR was 11.19%. Poor response (RFR below median) was found to be significantly associated with younger mean age and higher mean baseline GFR. On ROC analysis, the area under the curve value of baseline GFR for prediction of poor RFR was 0.714. Baseline GFR cut-off value of >65.50 mL/min/1.73m2, poor RFR was projected to be 92% sensitive and 48% specific for prediction of poor RFR. There were no adverse effect.
Conclusions:
The findings of the study showed that FRR assessment using vegetable protein load was feasible and safe in prospective kidney donors.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.