Yearly Trends of Chronic Kidney Disease III Progressions in Living Kidney Donors

Abstract

PURPOSE: We aim to see the rate of progression to chronic kidney disease stage III after living donor nephrectomy in a single institution annually.

METHODS: Between May 2006 and July 2017, a total of 753 living kidney donors who were followed up more than 6 months were enrolled in the study. We divided normal function vs chronic kidney disease III at 6 months postoperatively. We compared the incidence rate of chronic kidney disease stage III annually. For analysis, the entire period was divided into Era 1 (2006-2008), Era 2 (2009-2011), Era 3 (2012-2014), and Era 4 (2015-2017).

RESULTS: During the period, the incidence of chronic kidney disease stage III was 258 living donors (34.3%). The prevalence of chronic kidney disease stage III was 39.3%, 36.6%, 35.5%, and 29.3% in Era 1, Era 2, Era 3, and Era 4, respectively. The rate of chronic kidney disease stage III incidence serially decreased as the era passed (P = .046). There was no difference in age, smoking status, drinking status, body mass index, preoperative cholesterol, and uric acid among the eras. However, preoperative estimated glomerular filtration rate was 90.86 (SD, 4.12), 94.47 (SD, 16.62), 103.82 (SD, 0.68), and 105.66 (SD, 19.57) mL/min/1.73 m2 in Era 1, Era 2, Era 3, and Era 4, respectively (P = .001).

CONCLUSIONS: The incidence of chronic kidney disease stage III in living kidney donors for the last 3 years (Era 4) has decreased compared with the past (Era 1 and 2). The reason for this might be the effect of the change in the living donor guideline. Also, pre- and postoperative management method had an effect on renal function at 6 months.