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Tsujita M, Goto N, Futamura K, Okada M, Hiramitsu T, Narumi S, Uchida K, Morozumi K, Watarai Y. The importance of kidney volume as a marker in the assessment of living-donor kidney transplantation in Japan. Clin Exp Nephrol 2021; 25:537-544. [PMID: 33411116 DOI: 10.1007/s10157-020-02014-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 12/24/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND In living kidney transplantation, predicting the risk of end-stage kidney disease in the organ donors though crucial remains to be resolved. Thus, any useful biomarker to predict kidney outcome would be highly desirable to safeguard donors. METHODS This retrospective study was conducted at Nagoya Daini Red Cross Hospital to confirm whether an increase in preserved kidney volume (PKV) was a predict marker of proteinuria. A change of PKV before and 1 year after kidney donation was measured, and its association with proteinuria 3 years after the donation was analyzed. RESULTS A total of 119 kidney donors who met the Japanese donor guideline were enrolled. The mean age was 57.4 years, 46.2% were male. The mean values of the variables before kidney donation (baseline) were: BMI levels: 23.4 kg/m2, BSA-adjusted PKV: 132.9 cm3/1.73 m2, and estimated glomerular filtration rate (eGFRave): 82.9 mL/min/1.73 m2. A positive correlation was noted between BSA-adjusted PKV and eGFRave (r = 0.61, p < 0.001). BSA-adjusted PKV increased by 19.5% 1 year after donation, and the median urine protein was 0.04 g/gCre. Linear regression analyses showed that change of PKV and BSA-adjusted PKV before the donation were significantly associated with proteinuria 3 years after donation. CONCLUSION Change of PKV and BSA-adjusted PKV before donation is important factors for proteinuria after donation under the Japanese donor guidelines. Further studies are needed to confirm whether these factors are associated with renal survival after donation.
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Affiliation(s)
- Makoto Tsujita
- Department of Kidney Transplantation, Masuko Memorial Hospital, 35-28 Takebashi-cho, Nakamura-ku, Nagoya, 453-8566, Japan. .,Department of Kidney Disease Center, Transplant Nephrology and Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan.
| | - Norihiko Goto
- Department of Kidney Disease Center, Transplant Nephrology and Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - Kenta Futamura
- Department of Kidney Disease Center, Transplant Nephrology and Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - Manabu Okada
- Department of Kidney Disease Center, Transplant Nephrology and Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - Takahisa Hiramitsu
- Department of Kidney Disease Center, Transplant Nephrology and Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - Shunji Narumi
- Department of Kidney Disease Center, Transplant Nephrology and Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - Kazuharu Uchida
- Department of Kidney Transplantation, Masuko Memorial Hospital, 35-28 Takebashi-cho, Nakamura-ku, Nagoya, 453-8566, Japan
| | - Kunio Morozumi
- Department of Kidney Transplantation, Masuko Memorial Hospital, 35-28 Takebashi-cho, Nakamura-ku, Nagoya, 453-8566, Japan
| | - Yoshihiko Watarai
- Department of Kidney Disease Center, Transplant Nephrology and Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
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Shinoda K, Morita S, Akita H, Tamaki S, Takahashi R, Kono H, Asanuma H, Kikuchi E, Jinzaki M, Nakagawa K, Oya M. Pre-donation BMI and preserved kidney volume can predict the cohort with unfavorable renal functional compensation at 1-year after kidney donation. BMC Nephrol 2019; 20:46. [PMID: 30736760 PMCID: PMC6368798 DOI: 10.1186/s12882-019-1242-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 01/30/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The magnitude of renal function recovery after kidney donation differs in donors with a heterogeneous background. Preoperative assessment of candidates with potentially unfavorable renal functional compensation is critical when baseline kidney function is marginal. We explored the significance of preserved kidney volume (PKV) and known preoperative risk factors for the prediction of unfavorable renal function compensation. METHODS We enrolled 101 living donors for whom a 1-mm sliced enhanced computed tomography scan was performed preoperatively and clinical data could be collected up to 1 year after donation. The donors whose estimated glomerular filtration rate (eGFR) at 1 year after donation was 70% or higher of baseline eGFR were assigned to the "favorable renal compensation" group and the others to the "unfavorable renal compensation" group. RESULTS Age, sex, and preoperative serum uric acid level were not significant predictors for "unfavorable renal compensation." Multivariable logistic regression analysis revealed that body mass index (BMI) and body surface area (BSA)-adjusted PKV were independent preoperative risk factors for "unfavorable renal compensation" (adjusted odds ratio, 1.342 and 0.929, respectively). Hypertension and preoperative eGFR were not independent predictors when adjusted with BMI and BSA-adjusted PKV. Receiver operative characteristic analysis revealed that the predictive equation with the two independent predictors yielded a good accuracy to detect donor candidates with unfavorable renal functional compensation (area under the curve = 0.803), and the optimal cut-off values were identified as 23.4 kg/m2 for BMI and 107.3 cm3/m2 for BSA-adjusted PKV. CONCLUSIONS BMI and BSA-adjusted PKV may be useful to select candidates with potentially unfavorable renal function compensation before kidney donation.
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Affiliation(s)
- Kazunobu Shinoda
- Department of Urology, Keio University School of Medicine, Tokyo, 160-8582, Japan. .,Department of Nephrology, Toho University Faculty of Medicine, 7-5-23 Omorinishi Ota-ku, Tokyo, 143-0015, Japan.
| | - Shinya Morita
- Department of Urology, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Hirotaka Akita
- Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Satoshi Tamaki
- Department of Urology, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Ryohei Takahashi
- Department of Urology, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Hidaka Kono
- Department of Urology, Tokyo Dental College Ichikawa General Hospital, Chiba, 272-8513, Japan
| | - Hiroshi Asanuma
- Department of Urology, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Eiji Kikuchi
- Department of Urology, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Masahiro Jinzaki
- Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Ken Nakagawa
- Department of Urology, Tokyo Dental College Ichikawa General Hospital, Chiba, 272-8513, Japan
| | - Mototsugu Oya
- Department of Urology, Keio University School of Medicine, Tokyo, 160-8582, Japan
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