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Long-term Follow-up of Living Kidney Donors With Chronic Kidney Disease at 1 Year After Nephrectomy

Authors
 J C Na  ;  J S Park  ;  M-G Yoon  ;  H H Lee  ;  Y E Yoon  ;  K H Huh  ;  Y S Kim  ;  W K Han 
Citation
 Transplantation Proceedings, Vol.50(4) : 1018-1021, 2018 
Journal Title
 Transplantation Proceedings 
ISSN
 0041-1345 
Issue Date
2018
Abstract
BACKGROUND: Although renal function recovery of living kidney donors has been reported in a number of studies, many patients show poor recovery, and the long-term prognosis of these patients has not been well studied. In this investigation we explored the long-term prognosis of renal function in patients with chronic kidney disease (CKD) at 1 year after nephrectomy. METHODS: Patients who underwent donor nephrectomy during the period from March 2006 to April 2014, with a follow-up creatinine study at 1 year postoperatively and more than 3 years of follow-up, were included in the study. Creatinine and estimated glomerular filtration rate (eGFR, using the Modification of Diet in Renal Disease formula) before and after surgery were studied. Age, sex, history of hypertension or diabetes, body mass index, blood pressure, complete blood count, preoperative routine serum chemistry, and urine study results were reviewed. RESULTS: Among 841 patients who had donor nephrectomy, 362 were included in the study. There were 111 patients (30.6%) with eGFR <60 mL/min/1.73 m(2) at 1 year postsurgery, and the median follow-up period was 62.8 months (interquartile range [IQR] 42.0-86.3 months). The maximum eGFR after 3-year follow-up was studied, and 48 patients (43.2%) never recovered eGFR to >60 mL/min/1.73 m(2). Age, history of hypertension, preoperative eGFR, and eGFR at 1 year were predictive factors at univariate analysis. Multivariate analysis of these factors was studied, and age (52.5 [IQR 47-55.7] vs 47 [IQR 7-53] years, odds ratio [OR] 1.1, 95% confidence interval [CI] 1.02-1.15, P = .007), history of hypertension (16.7% vs 1.6%, OR 10.0, 95% CI 1.09-92.49, P = .042), and eGFR at 1 year (53.9 [IQR 50.3-56.0] vs 57.0 [IQR 54.2-58.4] mL/min/1.73 m(2), OR 0.8, 95% CI 0.72-0.92, P = .002) remained as significant risk factors. CONCLUSION: Of all living donors, 15.7% had CKD after >3 years of follow-up. Close observation is warranted when donors have CKD after 1 year follow-up, as 43.2% fail to recover renal function. Patients who are older, have a history of hypertension, and have low eGFR at 1-year follow-up are especially at risk.
Full Text
https://www.sciencedirect.com/science/article/pii/S0041134518301416
DOI
10.1016/j.transproceed.2018.02.053
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실)
Yonsei Authors
김유선(Kim, Yu Seun) ORCID logo https://orcid.org/0000-0002-5105-1567
나준채(Na, Joon Chae) ORCID logo https://orcid.org/0000-0003-4449-8472
박지수(Park, Jee Soo) ORCID logo https://orcid.org/0000-0001-9976-6599
윤영은(Yoon, Young Eun)
이형호(Lee, Hyung Ho)
한웅규(Han, Woong Kyu) ORCID logo https://orcid.org/0000-0002-2527-4046
허규하(Huh, Kyu Ha) ORCID logo https://orcid.org/0000-0003-1364-6989
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/162358
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