Renal function 27 years after unilateral nephrectomy for related donor kidney transplantation

Renal function in a living related kidney donor was evaluated 27 years after unilateral nephrectomy. The patient was normotensive and had no significant proteinuria. Creatinine was 0.8 mg. per dl. and creatinine clearance was 88 ml. per minute per 1.73 m.2 or 152 per cent of the single kidney pre-nephrectomy value. Tubular function assessed by the ability to lower urinary pH in response to an acid load was normal. Biopsy of the transplanted kidney 18 years after donation was histologically normal. This case represents one of the longest followup evaluations of a living related donor reported to date and it argues against any adverse effects of organ donation on the function of the remaining kidney.