10 Years Follow-up of Renal Function after Donor Nephrectomy

Park, Sung Yul; Park, Hae Young

Abstract

PURPOSE
In spite of the recognition of hyperfiltration injury after kidney donation, the function of the remaining kidney is considered relatively good. Few published reports have examined donor renal outcome after 10 years or later. We evaluated the effect of donor nephrectomy on donor renal outcome and the safety of the kidney donations.
METHODS
From January 1991 to August 1994, 205 living donor nephrectomies were performed. 32 donors were available for evaluation at minimum 10 years after the operation. Preoperative laboratory findings included blood urea nitrogen (BUN), serum creatinine, 24-hour creatinine clearance (CCr) and 24-hour urine protein. The same indices were checked at one month after the operation and at the last follow up and was compared with preoperative indices. The CCr was compared with an age adjusted glomerular filtration rate (AGFR) for normal kidney. Blood pressure was checked and compared with general population.
RESULTS
Mean patient follow up period was 11 years (10~15 years). BUN and serum creatinine increased, while CCr decreased from the preoperative levels, although still within normal limits. 24- hour urine protein was significantly increased from the preoperative level, and was higher than normal limits. CCr was not significantly different from AGFR. The incidence of hypertension was not higher than the general population.
CONCLUSION
Most of the renal indices are well preserved within normal limits at 10 years after donor nephrectomy. Urinary protein excretion increases with marginal significance but seems to be of no clinical significance in most patients. Prospective and longer term follow-up of the donors after donor nephrectomies are needed to establish the safety for the kidney donation.