Low GFR Post-Kidney Donation Not CKD

[Karol]

Jody A. Charnow
May 21, 2013
Low GFR Post-Kidney Donation Not CKD

SEATTLE—Living kidney donors should not be considered to have chronic kidney disease (CKD) if their renal function after nephrectomy falls to a level that usually would be considered CKD, researchers concluded in a study presented at the 2013 American Transplant Congress.

Many kidney donors have an estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73 m2 early post-donation and therefore meet the criteria for CKD stage 3, according to researchers. The prognosis of such a low GFR, however, may not be equivalent to the prognosis of the same GFR in patients with two diseased kidneys.

“I think we should consider former kidney donors as healthy people and not CKD patients,” said investigator Laura V. De Vries, BSc, a PhD candidate at University Medical Center Groningen, Groningen, The Netherlands.

She and her colleagues compared 57 post-donation kidney donors and 57 CKD patients who were matched for age, gender, GFR, and duration of follow-up. GFR was determined with 125I-iothalamate clearance.

In both groups, the mean age of study subjects was 48 years and the mean follow-up was 4.7 years. The donors and CKD patients had similar a GFR (67 and 70 mL/min/1.73 m2, respectively).

At the end of follow-up, donors had significantly better renal function than CKD patients, with a GFR of 73 versus 63 mL/min/1.72 m2, respectively. Serum creatinine levels decreased by 0.03 mg/dL in the donor group but increased by 0.03 in the CKD group. Additionally, GFR improved with time in all donors and declined in all CKD patients.

http://www.renalandurologynews.com/low-gfr-post-kidney-donation-not-ckd/article/294146/

[PastorJeff]

Thanks so much for posting this.  It takes away some angst.

[Donna Luebke]

“I think we should consider former kidney donors as healthy people and not CKD patients, said investigator Laura V. De Vries, BSc, a PhD candidate at University Medical Center Groningen, Groningen, The Netherlands....the mean follow-up was 4.7 years."


Her opinion as based on 57 donors--wonder what the criteria was when she selected these donors. 4.7 years of follow-up is meaningless.  Coming from The Netherlands suggests no donors of color were included. 

[brenda]

Note the details of the sample. At the beginning of the study, the post-donation patients had a mean eGFR = 67; this measure improved over 4 years. My pre-donation eGFR was 67; my post-donation eGFR has never risen above 45.  These studies are valuable, but only when we fit in the study group. Expanded criteria for donors, such as was used for me without my knowing, makes the most common research studies on donors inapplicable. Please be careful before choosing to proceed with donation - take your lab work to a nephrologist unrelated to the transplant center and ask if he or she would approve you for this surgery. 

Best wishes,
Brenda