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Updated: Feb 11, 2026
Single Port Donor Nephrectomy
Published on: March 12, 2011
Delayed Recovery of Renal Function After Donor Nephrectomy
1Department of Urology, Yonsei University College of Medicine, Urological Science Institute, Seoul, Republic of Korea.
Insights
Living kidney donors with a history of hypertension or high preoperative uric acid levels are less likely to recover kidney function after nephrectomy. Close monitoring is recommended for these individuals to manage potential chronic kidney disease (CKD).
Area of Science:
- Nephrology
- Transplantation Surgery
- Renal Medicine
Background:
- Living kidney donation carries a risk of chronic kidney disease (CKD) post-nephrectomy.
- Delayed renal function recovery is observed in some kidney donors after surgery.
Purpose of the Study:
- To investigate factors associated with delayed renal function recovery in living kidney donors one year after nephrectomy.
- To identify predictors of impaired renal function in this population.
Main Methods:
- Retrospective review of 275 living kidney donors with follow-up creatinine studies up to 3 years post-nephrectomy.
- Analysis of demographic, clinical, and laboratory data including preoperative and post-nephrectomy estimated glomerular filtration rate (eGFR).
Main Results:
- 83 donors (30.2%) had eGFR <60 mL/min/1.73 m² at 1 year; 57.8% of these showed functional recovery (>5 mL/min/1.73 m² improvement).
- Hypertension history, lower body mass index, and lower preoperative uric acid levels were associated with better eGFR recovery.
- Multivariate analysis identified hypertension history (OR 0.131) and uric acid level (OR 0.641) as significant factors influencing recovery.
Conclusions:
- A significant proportion of living kidney donors develop CKD one year post-nephrectomy, but over half experience functional improvement.
- History of hypertension and elevated preoperative uric acid levels are key predictors of poor renal function recovery.
- These findings underscore the need for close follow-up of kidney donors with these risk factors.
Background:
Many living kidney donors are still at risk of chronic kidney disease (CKD) 1 year after nephrectomy. Although some donors still experience poor renal function, many exhibit delayed recovery of renal function afterwards. We studied the factors related to delayed recovery of renal function in patients with CKD at 1 year after nephrectomy.
Methods:
Patients who underwent donor nephrectomy from March 2006 to April 2014 with a follow-up creatinine study at 1 month, 6 months, 1 year, and after 3 years of follow-up were included in the study. Age, sex, history of hypertension or diabetes, body mass index, blood pressure, complete blood cell count, preoperative routine serum chemistry, and urine study results were reviewed.
Results:
Among 275 donors, 83 (30.2%) who had an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 at 1 year of follow-up were included in the study, and the eGFR was observed during a median follow-up of 62.0 months (interquartile range [IQR], 48.9-83.1 months). Those who had improvements in eGFR of >5 mL/min/1.73 m2 were included in the recovery group (n = 48 [57.8%]), and those who did not were included in the nonrecovery group (n = 35 [42.2%]). The preoperative and 1-year follow-up eGFR did not differ significantly between the 2 groups, and the maximum eGFR after 3 years was higher in the recovery group (68.68 mL/min/1.73 m2 [IQR, 61.81-75.64 mL/min/1.73 m2] vs 55.63 mL/min/1.73 m2 [IQR, 51.73-58.29 mL/min/1.73 m2]; P < .001). The recovery group was more likely to have a history of hypertension (4.2% vs 20%; P = .032), a lower body mass index (24.11 kg/m2 [IQR, 22.04-25.20 kg/m2] vs 25.25 kg/m2 [IQR, 23.23-26.44 kg/m2]; P = .01), and a lower preoperative uric acid level (4.7 mg/dL [IQR, 3.8-5.4 mg/dL] vs 5.3 mg/dL [IQR, 4.4-6.2 mg/dL]; P = .031). After multivariate logistic regression analysis, history of hypertension (odds ratio, 0.131; P = .022) and uric acid level (odds ratio, 0.641; P = .036,) remained as significant factors.
Conclusions:
Although 30.2% of donors had CKD at 1 year after nephrectomy, 57.8% reported improved renal function. Those with a history of hypertension and high preoperative uric acid levels were less likely to have improvements in renal function and required close follow-up.
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