In:
American Journal of Physiology-Renal Physiology, American Physiological Society, Vol. 315, No. 6 ( 2018-12-01), p. F1550-F1554
Abstract:
Compensatory gomerular filtration rate (GFR) increase after kidney donation results in a GFR above 50% of the predonation value. The renal functional reserve (RFR) assessed by the renal response to dopamine infusion (RFR dopa ) is considered to reflect functional reserve capacity and is thought to be a tool for living donor screening. However, it is unknown if the RFR dopa predicts long-term kidney function. Between 1984 and 2017, we prospectively measured GFR ( 125 I-iothalamate) and RFR by dopamine infusion in 937 living kidney donors. We performed linear regression analysis of predonation RFR dopa and postdonation GFR. In donors with 5-yr follow-up after donation we assessed the association with long-term GFR. Mean donor age was 52 yr (SD 11); 52% were female. Mean predonation GFR was 114 ml/min (SD 22), GFR dopa was 124 ml/min (SD 24), resulting in an RFR of 9 ml/min (SD 10). Three months postdonation, GFR was 72 ml/min (SD 15) and GFR dopa was 75 ml/min (SD 15), indicating that donors still had RFR dopa [3 ml/min (SD 6), P 〈 0.001]. Predonation RFR dopa was not associated with predonation GFR [standardized (st.) β −0.009, P = 0.77] but was positively associated with GFR 3 mo after donation (st. β 0.12, P 〈 0.001). In the subgroup of donors with 5-yr follow-up data ( n = 383), RFR dopa was not associated with GFR at 5 yr postdonation (st. β 0.05, P = 0.35). In conclusion, RFR dopa is a predictor of short-term GFR after living kidney donation but not of long-term kidney function. Therefore, measurement of the RFR dopa is not a useful tool for donor screening. Studies investigating long-term renal adaptation are warranted to study the effects of living kidney donation and improve donor screening.
Type of Medium:
Online Resource
ISSN:
1931-857X
,
1522-1466
DOI:
10.1152/ajprenal.00064.2018
Language:
English
Publisher:
American Physiological Society
Publication Date:
2018
detail.hit.zdb_id:
1477287-5
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