The assessment of residual kidney function after living donor nephrectomy.
BACKGROUND
The number of patients on the waiting list for kidney transplantation is increasing as a result of the cadaveric donor shortage. One way to expand the pool is living donor transplantation. However, only 2% of kidney transplants in Poland come from living-related donors.


OBJECTIVE
We sought to assess residual renal function, incidence of hypertension, and proteinuria among living kidney donors.


METHODS
Between 2004 and 2007, we performed 46 living donor open nephrectomies. The mean age of the kidney donor was 39 years (range, 25-57). The donors were predominantly females (61%). Mean hospitalization time was 8 days (range, 4-22). Nine donors did not report for follow-up visits. The observation periods ranged from 1 to 24 months. Physical examination, blood and urine tests, as well as ultrasound scans were performed before nephrectomy and at every follow-up visit (1, 3, 12, and 24 months post operatively).


RESULTS
Mean creatinine concentration was higher at 3 months after nephrectomy than preoperatively (P < .05). Mean creatinine clearance according to Cockroft-Gault formula and mean creatinine clearance according to abbreviated modification of diet in renal disease equation (aMDRD) decreased after donation by 30% (P < .05). No cases of proteinuria were observed. Hypertension occurred in 1 donor (2.7%).


CONCLUSIONS
Living kidney donation resulted in a reduced creatinine clearance in the donor. Follow-up of living kidney donors is essential to determine risk factors for deterioration of residual kidney function.
Bieniasz
M
M
Department of General and Transplantation Surgery, Warsaw Medical University, Warsaw, Poland.
Domagala
P
P
Kwiatkowski
A
A
Gozdowska
J
J
Krzysztof
O
O
Kieszek
R A
RA
Trzebicki
J
J
Durlik
M
M
Rowinski
W
W
Chmura
A
A
D000328:Adult; D015992:Body Mass Index; D003404:Creatinine / Q000097:blood; D005190:Family; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007677:Kidney Function Tests; D007902:Length of Stay; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D011044:Poland; D011183:Postoperative Complications / Q000453:epidemiology; D011507:Proteinuria / Q000453:epidemiology; D035781:Siblings; D014019:Tissue Donors / Q000600:supply & distribution; D020858:Tissue and Organ Harvesting / Q000379:methods*
D003404:Creatinine