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Measured Glomerular Filtration Rate After Kidney Donation: No Evidence of Accelerated Decay

Berglund, Danielle M., BS1; Zhang, Lei, ScM2; Matas, Arthur J., MD3; Ibrahim, Hassan N., MD, MS4

doi: 10.1097/TP.0000000000002215
Original Clinical Science—General

Background The rate of measured glomerular filtration rate (GFR) change in kidney donor years after donation has not been adequately addressed. Whether this change is accelerated in the setting of 1 kidney is also understudied.

Methods Two hundred fourteen randomly selected donors underwent serial GFR measurements of nonradioactive iohexol. Estimated GFR at each visit was calculated using the Chronic Kidney Disease Epidemiology Collaboration and Modification of Diet in Renal Disease study equations.

Results Glomerular filtration rate visits were 4.8 ± 1.3 years apart and the second occurring 16.9 ± 9.1 years after donation. Most (97.7%) were white, 60.8% female, and 78.5% were related to their recipient. Most, 84.6%, had a GFR of 60 mL/min per 1.73 m2 or higher, 14.0% had a GFR between 45 and 60 mL/min per 1.73 m2, and 1.4% had a GFR less than 45 mL/min per 1.73 m2. Between visits 1 and 2, 56.5% had a GFR decline, 36.0% increase, and in 7.5%, there was no change. Overall, GFR declined at a rate of −0.42 mL/min per 1.73 m2 per year. Of GFR estimating models, only Chronic Kidney Disease Epidemiology Collaboration-Creatinine equation produced a slope that was steeper than measured GFR.

Conclusions Nearly 2 decades postdonation GFR declined at a rate similar to that seen in the general population, and in one third, GFR continues to increase.

Nearly 2 decades after living kidney donation, postdonation GFR declines at a rate similar to that seen in the general population and in one-third GFR continues to increase.

1 Informatics Services for Research and Reporting, Fairview Health Services, Minneapolis, MN.

2 Biostatistical Design and Analysis Center, University of Minnesota, Minneapolis, MN.

3 Department of Surgery, University of Minnesota, Minneapolis, MN.

4 Division of Renal Diseases and Hypertension, Houston Methodist Hospital, Houston, TX.

Received 26 December 2017. Revision received 2 February 2018.

Accepted 9 February 2018.

Funding for this research was provided by the National Institutes of Health as part of the PPG “Studies of Organ Transplantation in Animals and Man” (5P01 DK013083), RELIVE (Renal and Lung Living Donors Evaluation Study (AI069550-03) and National Center for Advancing Translational Sciences of the National Institutes of Health (UL1TR000114). The NIH had no role in study design, analysis, preparation or review of the article.

The authors declare no conflicts of interest.

D.B. participated in the performance of the research, preparation of the dataset, and writing of the article. L.Z. participated in data analysis and writing of the article. A.J.M. participated in research design, performance of the research, and writing of the article. H.N.I. participated in research design, performance of the research, and writing of the article.

Correspondence: Hassan N. Ibrahim, MD, MS, Division of Renal Diseases and Hypertension, Houston Methodist Hospital, 6550 Fannin St, Suite 1001 Houston, TX 77030. (hnibrahim@houstonmethodist.org).

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