Introduction:
Live donor kidney transplantation is the best possible option for patients reaching end stage renal disease. Despite the excellent outcome in recipient in terms of graft survival, evidence on donor outcome is conflicting and long term complications of kidney donation is uncertain.
Even though overall life expectancy of kidney donors is perceived to be comparable to normal population, risk of renal function deterioration and increased cardiovascular risk are of concern but yet to be explored. Thus, our study aims to assess the change in kidney function following donor nephrectomy and also aims to identify the associated comorbidities in a Sri Lankan cohort.
Methods:
This descriptive retrospective study was conducted at the donor clinic of Nephrology unit 1 at National Hospital of Sri Lanka from July 2021 to November 2021. A total of 102 donors who underwent donor nephrectomy since 2005 were included in this study.
Results:
Mean duration of the study population since the donation was 6 years with standard deviation of ± 3.20. The mean preoperative GFR was 95.61ml/min ±12.585 ,on discharge was 71.16±17.739 and the current GFR mean value is 75.88ml/min ± 17.2. Change in GFR suggest a statistically insignificant change with a P-Value of 0.062. All 102 (100%) people had preoperative eGFRs greater than 60 ml/min/1.73m2, while current values show that 72(70.6 %) of the study group has a value greater than 60 ml/min/1.73m2 and 30(29.4 %) has a value less than 60 ml/min/1.73m2.The difference in eGFR readings between preoperative and current states was discovered to be < 15 in 24 patients (23.5 % ). Between 15 and 30 were seen in 49 (48 %) of the study population, while eGFR alterations >30 were reported in 29 patients (28.4%).
The mean UPCR preoperatively was 0.026±0.044 which had changed to 0.13±0.190. Serum Creatinine levels increased in 89 (98.9%) of the study population while remaining unchanged in 1 (1.1%). Both UPCR and S creatinine values showed statistically insignificant change with donation during follow up (p value 0.332 and 0.119 respectively).
In terms of comorbidities, it was discovered that 18.8 percent (n=19) of patients had hypertension before surgery, and the prevalence of hypertension increased to 31.0 percent (n=31) after surgery. Preoperatively, obesity was found in 11.1%(n=11) and postoperatively there were 12.1%(n=12) cases associated with obesity.
Among the data on association between the GFR and the factors affecting the change in the kidney function there’s a statistically significant association between the age and GFR values with a P Value <0.001.However gender, smoking, BMI, income, duration since donation, frequency of follow up visits, comorbidities such as hypertension, type of donors did not show any association with GFR. Development of proteinuria had no association with any of the above factors.
Conclusions:
GFR value tends to drop immediate postoperatively, however there was no sustained further drop in GFR with time, similarly there was no statistically significant risk of development of proteinuria with kidney donation. According to our findings, older age was the only factor related with a higher likelihood of decrease in GFR following donor nephrectomy.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.