title: Predictive model of 1-year postoperative renal function after living donor nephrectomy.
abstract: OBJECTIVE
  Kidney transplantation from a living donor nephrectomy (LDN) is the best treatment for end-stage renal disease, but decrease in donor renal function is often revealed. The aim of this study was to evaluate the association between preoperative factors and postoperative estimated glomerular filtration rate (eGFR) and test a predictive model to estimate postoperative eGFR, 1 year after LDN.
  
  
  METHODS
  We reviewed 226 records of consecutive patients who underwent laparoscopic live donor nephrectomy between 2006 and 2014 in a single tertiary center. Of these, complete data on 202 patients were analyzed. A training (2/3 of the whole population) and a validation set (1/3) were randomized. A multivariate regression model was used to identify predictors and a formula to estimate of 1-year postoperative eGFR in the training set, using the CKD-EPI formula. Then, the formula was subjected to internal validation using the validation set using receiver operating characteristic (ROC) curves.
  
  
  RESULTS
  Two hundred and two LLDN were evaluated with a mean preoperative eGFR of 94.1 ± 15.5 ml/min/1.73 m2and postoperative eGFR of 64.6 ± 14.5 ml/min/1.73 m2(p < 0.0001). In multivariable analysis, age and preoperative eGFR were independent predictors of postoperative eGFR in the training set. A formula to estimate postoperative eGFR was generated with Pearson r = 0.70 in the training cohort and 0.65 in the validation cohort (both p < 0.0001). Area under the ROC curve of the formula was 0.89 in the training cohort and 0.83 in the validation cohort (both p < 0.0001).
  
  
  CONCLUSIONS
  Preoperative eGFR and age are predictors of postoperative eGFR after LDN. The internally validated predictive model of postoperative eGFR developed could be an accurate tool to improve the selection of LDN candidates.
authors.affiliation: Department of Urology, Andrology and Transplantation, Centre Hospitalier universitaire Toulouse-Rangueil, 1 avenue du Pr Jean Poulhes, 31059, Toulouse Cedex 9, France. thibaut.benoit31@gmail.com.
authors.forename: Thibaut
authors.initials: T
authors.lastname: Benoit
authors.affiliation: Department of Urology, Andrology and Transplantation, Centre Hospitalier universitaire Toulouse-Rangueil, 1 avenue du Pr Jean Poulhes, 31059, Toulouse Cedex 9, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Game
authors.affiliation: Department of Urology, Andrology and Transplantation, Centre Hospitalier universitaire Toulouse-Rangueil, 1 avenue du Pr Jean Poulhes, 31059, Toulouse Cedex 9, France.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Roumiguie
authors.affiliation: Department of Urology, Andrology and Transplantation, Centre Hospitalier universitaire Toulouse-Rangueil, 1 avenue du Pr Jean Poulhes, 31059, Toulouse Cedex 9, France.
authors.forename: Federico
authors.initials: F
authors.lastname: Sallusto
authors.affiliation: Department of Urology, Andrology and Transplantation, Centre Hospitalier universitaire Toulouse-Rangueil, 1 avenue du Pr Jean Poulhes, 31059, Toulouse Cedex 9, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Doumerc
authors.affiliation: Department of Urology, Andrology and Transplantation, Centre Hospitalier universitaire Toulouse-Rangueil, 1 avenue du Pr Jean Poulhes, 31059, Toulouse Cedex 9, France.
authors.forename: Jean Baptiste
authors.initials: JB
authors.lastname: Beauval
authors.affiliation: Department of Urology, Andrology and Transplantation, Centre Hospitalier universitaire Toulouse-Rangueil, 1 avenue du Pr Jean Poulhes, 31059, Toulouse Cedex 9, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Rischmann
authors.affiliation: Department of Nephrology and Transplantation, Centre Hospitalier universitaire Toulouse-Rangueil, Toulouse, France.
authors.forename: Nassim
authors.initials: N
authors.lastname: Kamar
authors.affiliation: Department of Urology, Andrology and Transplantation, Centre Hospitalier universitaire Toulouse-Rangueil, 1 avenue du Pr Jean Poulhes, 31059, Toulouse Cedex 9, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Soulie
authors.affiliation: Department of Urology, Andrology and Transplantation, Centre Hospitalier universitaire Toulouse-Rangueil, 1 avenue du Pr Jean Poulhes, 31059, Toulouse Cedex 9, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Malavaud
mesh_terms: D000328:Adult; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000601:surgery; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods*; D010535:Laparoscopy / Q000379:methods; D016014:Linear Models; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods; D012372:ROC Curve; D012189:Retrospective Studies; D013997:Time Factors; D060053:Transplant Donor Site / Q000503:physiopathology*
keywords: Laparoscopy; Living donor nephrectomy; Predictive model; Predictors; Renal function