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Insufficient early renal recovery and progression to subsequent chronic kidney disease in living kidney donors

Cited 4 time in Web of Science Cited 4 time in Scopus
Authors

Kim, Yaerim; Kang, Eunjeong; Chae, Dong-Wan; Lee, Jung Pyo; Lee, Sik; Kim, Soo Wan; Cho, Jang-Hee; Han, Miyeun; Han, Seungyeup; Kim, Yong Chul; Kim, Dong Ki; Joo, Kwon Wook; Kim, Yon Su; Lee, Hajeong

Issue Date
2022-09
Publisher
대한내과학회
Citation
The Korean Journal of Internal Medicine, Vol.37 No.5, pp.1021-1030
Abstract
© 2022 The Korean Association of Internal Medicine.Background/Aims: Renal recovery of a kidney donor after undergoing nephrectomy though challenging is essential. We aimed to examine the effect of estimated glomerular filtration rate (eGFR) percent change at 1-month post-donation on insufficient kidney function after kidney donation. Methods: A total of 3,952 living kidney donors who underwent donor nephrectomy from 1982 to 2019 from eight differ-ent tertiary hospitals in Korea were initially screened. Percent changes in the eGFR from baseline to 1-month post-donation were calculated. The degree of percent changes was categorized by quartile, and the 1st quartile was regarded as the group with the lowest decreased eGFR at 1-month after donation. The remaining eGFR less than 60 mL/min/1.73 m2 was the end-point. The Cox proportional hazard model was used for evaluating the impact of initial eGFR and eGFR percent change at 1-month post-donation on the condition with remaining eGFR < 60 mL/min/1.73 m2. In the multivariate analysis, we used variables with a p < 0.1 in the univariate analysis. Results: A total of 1,585 donors were included in the analysis. During 62.2 ± 49.3 months, 13.7% of donors showed renal insufficiency. The 4th (adjusted hazard ratio [aHR], 10.41; 95% confidence interval [CI], 5.15 to 21.04) and the 3rd (aHR, 4.29; 95% CI, 2.15 to 8.56) quartiles of percent change in eGFR and the pre-donation eGFR (aHR, 0.90; 95% CI, 0.88 to 0.92) were associated with the development of renal insufficiency. Conclusions: The impact of worse initial renal recovery on renal insufficiency was pronounced in donors with lower pre-donation eGFRs. Additionally, worse initial renal recovery of remaining kidney affected the long-term development of renal insufficiency in kidney donors.
ISSN
1226-3303
URI
https://hdl.handle.net/10371/205440
DOI
https://doi.org/10.3904/kjim.2021.308
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  • College of Medicine
  • Department of Medicine
Research Area Nephrology, Transplantation, Urology

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