Baseline living-donor kidney volume and function associate with 1-year post-nephrectomy kidney function.

Area of Science:

• Nephrology
• Transplantation
• Radiology

Background:

• Living kidney donors may experience reduced kidney function post-donation.
• Assessing remaining kidney volume is crucial for predicting long-term renal health.

Purpose of the Study:

• To investigate the association between computed tomography-assessed remaining kidney volume indexed to body surface area (RKV/BSA) and 1-year post-nephrectomy renal function.
• To determine if RKV/BSA predicts renal function independently of baseline renal function.

Main Methods:

• Multivariable regression analysis was used to model 1-year estimated glomerular filtration rate (eGFR) and the incidence of eGFR <60 mL/min/1.73 m².
• 151 consecutive living kidney donors were analyzed, considering pre-determined baseline eGFR subgroups.
• Computed tomography-assessed RKV/BSA was the primary predictor variable.

Main Results:

• Higher baseline RKV/BSA was associated with higher baseline and 1-year eGFR.
• Each standard deviation increase in RKV/BSA independently predicted a 2.4 mL/min/1.73 m² higher adjusted 1-year eGFR.
• Adjusted odds of 1-year eGFR <60 mL/min/1.73 m² significantly increased for donors with RKV/BSA <80 mL/m², particularly those with lower baseline eGFR.

Conclusions:

• RKV/BSA is an independent predictor of 1-year renal function after kidney donation.
• RKV/BSA is especially valuable in identifying donors at risk for renal dysfunction when baseline eGFR is low.
• Further research is warranted to explore the clinical utility of RKV/BSA in donor selection and informed consent processes.