Early Compensatory Hypertrophy in Living Kidney Donors: Sequential Changes in Ultrasonographic Renal Volume and MAG3-Derived Renal Plasma Flow

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Abstract Title *

Early Compensatory Hypertrophy in Living Kidney Donors: Sequential Changes in Ultrasonographic Renal Volume and MAG3-Derived Renal Plasma Flow

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Co-author 1

Hajime Hirano hirano.hajime@twmu.ac.jp Tokyo Women’s Medical University Department of Blood Purification Tokyo Japan * Osaka Medical and Pharmaceutical University Hospital Blood Purification Center Osaka Japan

Co-author 2

Tomohisa Matsunaga tomohisa.matsunaga@ompu.ac.jp Osaka Medical and Pharmaceutical University Hospital Blood Purification Center Osaka Japan -

Co-author 3

Takahiro Inoue inoue.takahiro@twmu.ac.jp Tokyo Women’s Medical University Department of Blood Purification Tokyo Japan -

Co-author 4

Yu Munakata plumeriagarden@hotmail.co.jp Tokyo Women’s Medical University Department of Blood Purification Tokyo Japan -

Co-author 5

Tetsuro Machimura machimura.tetsuro@twmu.ac.jp Tokyo Women’s Medical University Department of Blood Purification Tokyo Japan -

Co-author 6

Norio Hanafusa hanafusa@twmu.ac.j Tokyo Women’s Medical University Department of Blood Purification Tokyo Japan -

Co-author 7

Haruhito Azuma haruhito.azuma@ompu.ac.jp Osaka Medical and Pharmaceutical University Hospital Blood Purification Center Osaka Japan -

Co-author 8

Co-author 9

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

The temporal relationship between functional and morphological changes after kidney donation remains unclear. This study evaluated compensatory adaptation using ultrasonographic renal volume and MAG3-derived renal plasma flow (RPF).

Methods

34 living kidney donors (mean age 60.5 ± 11.1 years; 9 males, 25 females) were evaluated at baseline and 1, 6, and 12 months post-donation. eGFR, MAG3-RPF, and renal volume were measured and analyzed using mixed-effects models.

Results

MAG3-RPF increased markedly at 1 month (163.8 ± 32.6% of baseline) and stabilized at 158.1 ± 21.5% by 12 months. Renal volume increased progressively to 121.9 ± 12.6% at 1 month and 142.4 ± 14.4% at 12 months. eGFR recovered to 53.6 mL/min/1.73m² at 12 months (82% of baseline) and remained stable thereafter. Pre-donation split renal function correlated strongly with 12-month eGFR (r = 0.65, p < 0.01). No significant differences in recovery rates were observed by sex or age.

Conclusion

Functional and structural compensatory changes occur early after nephrectomy, with functional adaptation evident within the first month and morphological hypertrophy progressing over 12 months. Both parameters stabilize by 6–12 months. Combined assessment using MAG3 and ultrasonography provides integrated evaluation of compensatory adaptation in living kidney donors.

Kewords