Age and Pre-operative HbA1c Levels Affect Renal Function Compensation in Living Kidney Donors

Overview

Journal Int Urol Nephrol

Publisher Springer

Specialty Nephrology

Date 2023 Nov 30

PMID 38032440

Authors

Taihei Ito

Takashi Kenmochi

Kei Kurihara

Naohiro Aida

Midori Hasegawa

Takuma Ishihara

Ayumi Shintani

Affiliations

Soon will be listed here.

Abstract

Objectives: About 90% of Japanese kidney transplantations are conducted from living donors, and their safety and the maintenance of their renal function are critical. This study aims to identify factors that affect the compensation of renal function in living kidney donors after donor nephrectomy.

Method: In a retrospective cohort study, we reviewed data from 120 patients who underwent nephrectomy as living kidney transplant donors in our department from 2012 to 2021. Univariable and multivariable linear regression analyses were performed for donor factors affecting renal function after donor nephrectomy.

Result: The multivariable linear regression model revealed that the donor's age (p = 0.025), preoperative estimated Glomerular Filtration Rate (eGFR) (p < 0.001), and hemoglobin A1c (HbA1c) (p = 0.043) were independent risk factors for eGFR at six months after nephrectomy. The eGFR deterioration was more strongly associated with age in females than in males, whereas higher HbA1c values were more strongly associated with eGFR deterioration in males. Higher donor age and higher HbA1c each enhance the deterioration of eGFR six months after living donor nephrectomy. The data suggest that old age in especially female donors and preoperative higher HbA1c in male donors have a harmful impact on their renal function compensation.

References

Egawa H, Tanabe K, Fukushima N, Date H, Sugitani A, Haga H . Current status of organ transplantation in Japan. Am J Transplant. 2011; 12(3):523-30. DOI: 10.1111/j.1600-6143.2011.03822.x. View

Fukushima N, Ono M, Saiki Y, Sawa Y, Nunoda S, Isobe M . Registry Report on Heart Transplantation in Japan (June 2016). Circ J. 2017; 81(3):298-303. DOI: 10.1253/circj.CJ-16-0976. View

Ito T, Kenmochi T, Aida N, Kurihara K, Tomimaru Y, Ito T . Impact of the revision of the law on pancreatic transplants in Japan-An analysis of the Japanese Pancreas Transplants Registry. J Hepatobiliary Pancreat Sci. 2021; 28(4):353-364. DOI: 10.1002/jhbp.911. View

Soyama A, Eguchi S . The current status and future perspectives of organ donation in Japan: learning from the systems in other countries. Surg Today. 2015; 46(4):387-92. DOI: 10.1007/s00595-015-1211-6. View

Soyama A, Eguchi S, Egawa H . Liver transplantation in Japan. Liver Transpl. 2016; 22(10):1401-7. DOI: 10.1002/lt.24502. View

Sakamoto K, Ogawa K, Takai A, Tamura K, Iwata M, Ito C . Laparoscopic clamp-crushing enucleation with a pancreatic duct stent for tumors located close to the main pancreatic duct. Surg Today. 2021; 52(4):721-725. DOI: 10.1007/s00595-021-02428-w. View

Song T, Fu L, Huang Z, He S, Zhao R, Lin T . Change in renal parenchymal volume in living kidney transplant donors. Int Urol Nephrol. 2013; 46(4):743-7. DOI: 10.1007/s11255-013-0592-y. View

Chen K, Wu M, Chen Z, Tai B, Goh Y, Lata R . Compensatory Hypertrophy After Living Donor Nephrectomy. Transplant Proc. 2016; 48(3):716-9. DOI: 10.1016/j.transproceed.2015.12.082. View

Tan J, Busque S, Workeneh B, Ho B, Derby G, Blouch K . Effects of aging on glomerular function and number in living kidney donors. Kidney Int. 2010; 78(7):686-92. PMC: 3353650. DOI: 10.1038/ki.2010.128. View

10.

Harrell Jr F, Lee K, Mark D . Multivariable prognostic models: issues in developing models, evaluating assumptions and adequacy, and measuring and reducing errors. Stat Med. 1996; 15(4):361-87. DOI: 10.1002/(SICI)1097-0258(19960229)15:4<361::AID-SIM168>3.0.CO;2-4. View

11.

Kanda Y . Investigation of the freely available easy-to-use software 'EZR' for medical statistics. Bone Marrow Transplant. 2012; 48(3):452-8. PMC: 3590441. DOI: 10.1038/bmt.2012.244. View

12.

Kasiske B, Ma J, Louis T, Swan S . Long-term effects of reduced renal mass in humans. Kidney Int. 1995; 48(3):814-9. DOI: 10.1038/ki.1995.355. View

13.

Nolan C, Norman J, Page W, Miller P, Meyer T . Forty-five year follow-up after uninephrectomy. Kidney Int. 1993; 43(5):1110-5. DOI: 10.1038/ki.1993.156. View

14.

Najarian J, Chavers B, McHugh L, Matas A . 20 years or more of follow-up of living kidney donors. Lancet. 1992; 340(8823):807-10. DOI: 10.1016/0140-6736(92)92683-7. View

15.

Anderson R, Bueschen A, Lloyd L, Dubovsky E, Burns J . Short-term and long-term changes in renal function after donor nephrectomy. J Urol. 1991; 145(1):11-3. DOI: 10.1016/s0022-5347(17)38232-0. View

16.

Muzaale A, Massie A, Wang M, Montgomery R, McBride M, Wainright J . Risk of end-stage renal disease following live kidney donation. JAMA. 2014; 311(6):579-86. PMC: 4411956. DOI: 10.1001/jama.2013.285141. View

17.

Mason R, Ewald B . Studies on compensatory renal hypertrophy. I. Effect of unilateral ureteral ligation and transection. Proc Soc Exp Biol Med. 1965; 120(1):210-4. DOI: 10.3181/00379727-120-30488. View

18.

Pollock C, Field M . Compensatory renal hypertrophy: tubular cell growth and transport studied in primary culture. Nephron. 1993; 64(4):615-20. DOI: 10.1159/000187410. View

19.

Salehmoghaddam S, Bradley T, Mikhail N, Nord E, Trizna W, Kheyfets R . Hypertrophy of basolateral Na-K pump activity in the proximal tubule of the remnant kidney. Lab Invest. 1985; 53(4):443-52. View

20.

Pfaller W, Seppi T, Ohno A, Giebisch G, Beck F . Quantitative morphology of renal cortical structures during compensatory hypertrophy. Exp Nephrol. 1998; 6(4):308-19. DOI: 10.1159/000020538. View