Renal Functional Reserve Capacity before and after Living Kidney Donation

Marco van Londen*, Nicolien Kasper, Niek R Hessels, A Lianne Messchendorp, Stephan J L Bakker, Jan-Stephan F Sanders, Stefan P Berger, Martin H de Borst, Gerjan Navis

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

7 Citaten (Scopus)
4 Downloads (Pure)

Samenvatting

Compensatory GFR increase after kidney donation results in a GFR above 50% of the pre-donation value. The Renal Functional Reserve assessed by the renal response to dopamine infusion (RFRdopa) is considered to reflect functional reserve capacity and thought to be a tool for living donor screening. However, it is unknown if the RFRdopa predicts long-term kidney function. Between 1984 and 2017, we prospectively measured mGFR (125-I-Iothalamate) and RFR by dopamine infusion in 937 living kidney donors. We performed linear regression analysis of pre-donation RFRdopa and post-donation GFR. In donors with 5-year follow-up after donation we assessed the association with long-term GFR. Mean donor age was 52{plus minus}11 years, 52% were female. Mean pre-donation GFR was 114{plus minus}22 ml/min, GFRdopa was 124{plus minus}24 ml/min, resulting in a RFR of 9{plus minus}10 ml/min. Three months post-donation, GFR was 72{plus minus}15 ml/min and GFRdopa was 75{plus minus}15 ml/min, indicating that donors still had RFRdopa (3{plus minus}6 ml/min, P<0.001). Pre-donation RFRdopa was not associated with pre-donation GFR (st. β -0.009, P=0.77), but was positively associated with GFR 3 months after donation (st. β 0.12, P<0.001). In the subgroup of donors with 5-year follow-up data (n=383), RFRdopa was not associated with GFR at 5 years post-donation (st. β 0.05, P=0.35). In conclusion, RFRdopa is a predictor of short-term GFR after living kidney donation, but not of long-term kidney function. Therefore, measurement of the RFRdopa is not a useful tool for donor screening. Studies investigating long-term renal adaptation are warranted to study the effects of living kidney donation and improve donor screening.

Originele taal-2English
Pagina's (van-tot)F1550-F1554
Aantal pagina's5
TijdschriftAmerican journal of physiology-Renal physiology
Volume315
Nummer van het tijdschrift6
DOI's
StatusPublished - dec-2018

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