J Korean Soc Transplant.  2007 Jun;21(1):75-80.

Long-term Change of Renal Function after Donor Nephrectomy for Kidney Transplantation

• Chang HK
• Ju MK
• Ahn HJ
• Kim HJ
• Jeon KO
• Kim MS
• Kim SI
• Kim YS

Abstract

PURPOSE: Occurrence of renal failure and its related complications such as hypertension are long-term problems after donor nephrectomy for living donor kidney transplantation. We retrospectively reviewed renal function of unilateral kidney donor.
METHODS
From 669 living donors for kidney transplantation from December 1998 to October 2006, laboratory data related to renal function are collected from hospital medical record retrospectively in 251 (37.5%) donors who were followed-up after discharge. The selection criteria of donors were: 1) pre-nephrectomy serum creatinine level below 1.5 mg/dL, 2) no radiologic abnormality in bilateral kidney. The donor nephrectomy was performed by conventional open nephrectomy or video assisted minilaparotomy surgery. The estimated glomerular filtration rate (e-GFR) by Modification of Diet in Renal Disease (MDRD) study was used as renal function monitoring parameter.
RESULTS
In immediate post-nephrectomy period, e-GFR was decreased to 67.8+/-4.6% of pre-nephrectomy level (93.8+/-9.9 mL/min/1.73 m2). The urinary protein excretion for 24 hours was increased to 255% of pre-nephrectomy level (76.4+/-4.6 mg/day), but cases with proteinuria more than 300 mg per day were only 4 cases (1.7%, 4/251). After 14.0+/-5.2 months follow-up (range: 1~80 months), two cases (0.8%, 2/251) of renal failure (chronic kidney disease stage 5) were found. Relative renal function (post-nephrectomy e-GFR ratio versus pre-nephrectomy e-GFR, %) was increased by post-nephrectomy duration. The mean scores of e-GFR ratio within post-nephrectomy 2 months, 3~11 months, 12~23 months and after 24 months were 64.8+/-10.4%, 66.4+/-9.7%, 69.5+/-10.9% and 75.8+/-17.6% respectively. The relative e-GFR ratio after 24 months was significantly different from those of within 24 months (P<0.0001 by ANOVA). In linear regression analysis, mean increment of e-GFR ratio per post-nephrectomy year was 2.88%.
CONCLUSION
In spite of possibility of renal failure, our study shows the long-term compensation of residual renal function after nephrectomy.

Keyword

Kidney donor; Nephrectomy; Renal function

MeSH Terms

Compensation and Redress
Creatinine
Diet
Follow-Up Studies
Glomerular Filtration Rate
Humans
Hypertension
Kidney Diseases
Kidney Transplantation*
Kidney*
Laparotomy
Linear Models
Living Donors
Medical Records
Nephrectomy*
Patient Selection
Proteinuria
Renal Insufficiency
Retrospective Studies
Tissue Donors*
Creatinine