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Related Concept Videos

Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

69
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Factors Affecting Renal Clearance: Renal Impairment01:17

Factors Affecting Renal Clearance: Renal Impairment

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Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
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Serum Studies: Renal Function Tests01:24

Serum Studies: Renal Function Tests

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Renal function tests are crucial for assessing kidney health, monitoring disease progression, and evaluating the kidneys' efficiency in waste elimination, fluid balance, and electrolyte regulation. These tests offer critical insights into kidney function, even though routine measurements may appear normal until there is a significant decline in the glomerular filtration rate or GFR. Typically, signs of kidney impairment only become evident when the GFR falls to about 50% of its normal level.
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Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
86
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

182
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
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Acute Kidney Injury I: Introduction01:22

Acute Kidney Injury I: Introduction

120
Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
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Murine Renal Transplantation Procedure
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Assessing Renal Function for Kidney Donation. How Low Is Too Low?

Gustavo Laham1, Juan Pablo Ponti1, Gervasio Soler Pujol1

  • 1Internal Medicine Department, Nephrology Section, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno (CEMIC), Buenos Aires, Argentina.

Frontiers in Medicine
|February 21, 2022
PubMed
Summary

Living kidney donors face potential risks of end-stage kidney disease (ESKD) due to reduced glomerular filtration rate (GFR) after donation. Accurate GFR assessment is crucial for donor safety and eligibility.

Keywords:
end stage kidney disease (ESKD)estimated GFRglomerular filtration ratekidney transplantmeasure GFR

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Area of Science:

  • Nephrology
  • Transplant Surgery
  • Public Health

Background:

  • Kidney transplantation (KT) is optimal for end-stage kidney disease (ESKD), but organ shortages increase reliance on living donors.
  • Concerns exist regarding increased ESKD risk in living kidney donors post-donation, possibly linked to reduced glomerular filtration rate (GFR).
  • Proper donor assessment is vital to balance recipient needs with donor safety, particularly concerning kidney function thresholds.

Purpose of the Study:

  • To investigate the factors influencing ESKD risk in living kidney donors.
  • To highlight the importance of accurate glomerular filtration rate (GFR) assessment in donor evaluation.
  • To discuss the variability in GFR assessment methods and their impact on donor selection criteria.

Main Methods:

  • Review of existing literature on kidney donor assessment and ESKD risk.
  • Analysis of glomerular filtration rate (GFR) measurement techniques, including direct measurement (mGFR), creatinine clearance (CrCl), and estimated GFR (eGFR).
  • Discussion of demographic factors (age, gender, race) influencing GFR and potential donor eligibility.

Main Results:

  • Living kidney donors may face a higher risk of ESKD post-donation.
  • Reduced GFR post-nephrectomy is a potential contributor to increased ESKD risk.
  • Current GFR assessment methods have limitations, with CrCl overestimating and eGFR underestimating true GFR.

Conclusions:

  • Accurate GFR assessment is critical for evaluating living kidney donor safety and eligibility.
  • Guidelines for kidney function thresholds in donors require careful consideration of measurement methods and demographic factors.
  • Combining GFR measurement methods may offer a more reliable assessment of kidney function for potential donors.