What is the significance of end-stage renal disease risk estimation in living kidney donors?
Two end-stage renal disease (ESRD) risk calculators were recently developed by Grams et al., and Ibrahim et al. to calculate ESRD risk before donation among living kidney donors. However, those calculators have never been studied among potential donors for whom donation was refused due to medical contraindications and compared to a group of donors. We compared 15-year and lifetime ESRD risk of donors and nondonors due to medical cause as estimated by those two calculators. Nondonors due to medical cause (n = 27) had a significantly higher 15-year ESRD risk compared to donors (n = 288) with both calculators (0.25 vs. 0.14, P < 0.001 for that developed by Grams et al. and 2.21 vs. 1.43, P = 0.002 for that developed by Ibrahim et al.). On the contrary, lifetime ESRD risk was not significantly different between the two groups. At both times (15 years and lifetime), we observed a significant overlap of ESRD risk between the two groups. ESRD risk calculators could be complementary to standard screening strategy but cannot be used alone to accept or decline donation.
Renal Transplantation Department, AP-HP, Hôpital Necker-Enfants Malades, Paris Descartes University, Paris, France.
François
F
Gaillard
Physiology Department, AP-HP, Hôpital Européen Georges Pompidou, Paris Descartes University, Paris, France.
Stéphanie
S
Baron
Urology Department, AP-HP, Hôpital Européen Georges Pompidou, Paris Descartes University, Paris, France.
Marc-Olivier
MO
Timsit
Unit 970, Physiology Department, AP-HP, Hôpital Européen Georges Pompidou, Paris Descartes University, and INSERM, Paris, France.
Dominique
D
Eladari
Renal Transplantation Department, AP-HP, Hôpital Necker-Enfants Malades, Paris Descartes University, Paris, France.
Catherine
C
Fournier
Physiology Department, AP-HP, Hôpital Européen Georges Pompidou, Paris Descartes University, Paris, France.
Caroline
C
Prot-Bertoye
Physiology Department, AP-HP, Hôpital Européen Georges Pompidou, Paris Descartes University, Paris, France.
Jean-Philippe
JP
Bertocchio
Anesthesia and Intensive Care Department, AP-HP, Hôpital Necker-Enfants Malades, Paris Descartes University, Paris, France.
Lionel
L
Lamhaut
Unit 1151, Physiology Department, AP-HP, Hôpital Européen Georges Pompidou, Paris Descartes University, and INSERM, Paris, France.
Gérard
G
Friedlander
Urology Department, AP-HP, Hôpital Européen Georges Pompidou, Paris Descartes University, Paris, France.
Arnaud
A
Méjean
Renal Transplantation Department, AP-HP, Hôpital Necker-Enfants Malades, Paris Descartes University, Paris, France.
Christophe
C
Legendre
Unit 1151, Physiology Department, AP-HP, Hôpital Européen Georges Pompidou, Paris Descartes University, and INSERM, Paris, France.
Marie
M
Courbebaisse
D000328:Adult; D000075204:Contraindications, Procedure; D046148:Donor Selection; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology*; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects*; D012306:Risk; D020858:Tissue and Organ Harvesting / Q000009:adverse effects; D009927:Tissue and Organ Procurement
end-stage renal disease risk; living donors; monocentric; online calculators; renal transplantation; retrospective