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Renal function studies after donor nephrectomy.

J Ewald, M Aurell

    Scandinavian Journal of Urology and Nephrology
    |March 6, 1975
    PubMed
    Summary
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    Kidney donors experience compensatory hypertrophy, with proximal tubular functions like maximal tubular secretion of para-aminohippurate (TmPAH) increasing more than glomerular filtration rate (GFR) after nephrectomy.

    Area of Science:

    • Nephrology
    • Renal Physiology

    Background:

    • Compensatory hypertrophy occurs in the remaining kidney post-nephrectomy.
    • Previous studies noted increased renal plasma flow (RPF) and glomerular filtration rate (GFR).
    • Tubular function changes in kidney donors remain understudied.

    Purpose of the Study:

    • To investigate tubular function changes in elderly kidney donors after nephrectomy.
    • To assess maximal tubular secretion of para-aminohippurate (TmPAH), acid excretion, and urinary concentration ability.

    Main Methods:

    • Nine elderly kidney donors (mean age 55) were studied pre- and post-nephrectomy (6 and 12 months).
    • Evaluated parameters included GFR, RPF, TmPAH, net acid excretion, and urinary concentration ability.
    • Ammonium chloride loading was used to assess acid excretion.

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    Main Results:

    • Postoperative RPF and GFR decreased to 61% and 63.5% respectively, with an increased filtration fraction.
    • TmPAH decreased less significantly (76% at 6 months, 86% at 12 months).
    • The TmPAH/GFR ratio increased postoperatively, indicating altered glomerulotubular balance. Acidification and concentration abilities remained largely unchanged.

    Conclusions:

    • The remaining kidney exhibits compensatory hypertrophy with increased RPF and GFR post-nephrectomy.
    • Energy-dependent proximal tubular functions (TmPAH) show a greater increase than GFR.
    • Distal tubular functions, including acidification and urinary concentration, are generally preserved.