Estimated GFR at Donor Screening to Predict mGFR after Living Kidney Donation.

J. van der Weijden, M. van Londen, S.J.L. Bakker, G.J. Navis, M.H. de Borst

Thursday 15 march 2018

16:55 - 17:05h at Van Rijck/Ruys Zaal

Categories: Clinical, Session (parallel)

Parallel session: Parallel session 10: Transplant coordination

Introduction

Accurate pre-donation renal function estimation is important to minimize the risk of future severe renal function impairment in living kidney donors. Recent studies focused on pre-donation estimated GFR (eGFR) as predictor of measured GFR (mGFR), but did not account for the effect of nephrectomy.

Aim

In this study, we aimed to identify the predictive value of pre-donation eGFR for post-donation mGFR.

Methods

In 873 living kidney donors, eGFR (CKD-EPI formula) and mGFR (125I-iothalamate) were measured before and 3 months after donation. Bayesian statistics were used to calculate for different pre-donation eGFR categories the probability of having a post-donation mGFR above the thresholds 40, 45, 50, 55 and 60 mL/min/1.73m².

Results

Mean donor age was 52±1 and 48% were male. Mean pre-donation eGFR was 88±14 mL/min/1.73m² and mean pre-donation mGFR/BSA was 102±16 ml/min/1.73m² respectively. Mean post-donation mGFR/BSA was 65±12 ml/min/1.73m². Pre-donation eGFR was associated with post-donation mGFR (st. β. 0.48 p < 0.001). In order to achieve a post-donation mGFR > 40ml/min/1.73m2 with a probability of 95%, a pre-donation eGFR > 69 ml/min/1.73m2 was necessary. This was present in 91% of donors. A pre-donation eGFR > 94 mL/min/1.73m² was needed to reach a post-donation mGFR > 50 mL/min/1.73m² with a probability of 95%. This was present in 33% of the donors.

Conclusions

This study shows that pre-donation eGFR can be used to predict post-donation mGFR and provides pre-donation eGFR cut-off values with 95% predictive value for post-donation mGFR.