The assessment of residual kidney function after living donor nephrectomy

Background: The number of patients on the waiting list for kidney transplantation is increasing as a result of cadaveric donor's shortage. One of the ways to expand the donor pool is living donor transplantation. However, only 2-3% of kidney transplants in Poland are obtained from the living related donors. The aim of this study was to assess residual renal function and incidence of microalbuminuria in living kidney donors.
Material/Methods: Between 1995 and 2005, 66 living donor open nephrectomies
were performed. Physical examination, blood and urine tests and ultrasonography were performed prior to nephrectomy and at every follow-up visit (every 12 months post-op) in the donors. Donor mean age was 40.9 years (range 29-60). The donors were predominantly female (52.5%). 27 donors did not report for follow-up visits. Observation period ranged from 36 to 156 months.
Results: Mean creatinine concentration increased from 0.89 mg/dl prior to donation to 1.12 mg/dl and 1.1 mg/dl at 36 and 84 months post nephrectomy, respectively. Mean creatinine clearance according to the Cockroft-Gault formula decreased from 94.27 ml/min prior to donation to 80.2 ml/min and 72.2 ml/min at 36 and 84 months post donation, respectively. Microalbuminuria was observed in one patient (2.6%) at 84 months following nephrectomy.
Conclusions: Living kidney donation results in a reduced creatinine clearance in the donor. Follow-up of living kidney donors is essential in determining risk factors for deterioration of residual kidney function.

Keywords: Kidney Transplantation