Living kidney donor estimated glomerular filtration rate and recipient graft survival

Ann Young, S. Joseph Kim, Amit X. Garg, Anjie Huang, Greg Knoll, G. V. Ramesh Prasad, Darin Treleaven, Charmaine E. Lok, Jennifer Arnold, Neil Boudville, Ann Bugeya, Christine Dipchand, Mona Doshi, Liane Feldman, Amit Gerg, Colin Geddes, Eric Gibney, John Gill, Martin Karpinski, Joseph KimScott Klarenbach, Charmaine Laok, Philip McFarlane, Mauricio Monroy-Cuadros, Norman Muirhead, Immaculate Nevis, Christopher Y. Nguan, Chirag Parikh, Emilio Poggio, G. V. Ramesh Prasad, Leroy Storsley, Ken Taub, Sonia Thomas, Darin Traleaven, Ann Youeng

Research output: Contribution to journalArticlepeer-review

Abstract

BackgroundKidney transplants from living donors with an estimated glomerular filtration rate (eGFR) < 80 mL/min per 1.73 m2 may be at risk for increased graft loss compared with a recipient who receives a kidney from a living donor with a higher eGFR.MethodsThis retrospective cohort study considered 2057 living kidney donors and their recipients from July 1993 to March 2010 at five centres in Ontario, Canada, and linked them to population-based, universal healthcare databases. Recipients were divided into five groups based on their donor's baseline eGFR. The median (inter-quartile range) for the lowest eGFR group was 73 (68-77) mL/min per 1.73 m2. Subjects were followed for a median of 6 years (IQR: 3-10 years).ResultsThere was no significant difference in the adjusted hazard ratio (HR) for graft loss when comparing recipients in each eGFR category to the referent group (≥110 mL/min per 1.73 m2). The adjusted HRs (95% CI) from the lowest (<80 mL/min per 1.73 m2) to highest (100-109.9 mL/min per 1.73 m2) eGFR categories were 1.27 (0.84-1.92), 1.43 (0.96-2.14), 1.23 (0.86-1.77) and 1.23 (0.85-1.77), respectively. Similar results were observed when dichotomizing the baseline donor eGFR using a cut-point of 80 mL/min per 1.73 m2-adjusted HR 1.01 [95% confidence interval (95% CI) (0.76-1.44)].ConclusionsFurther research in this setting should clarify whether additional tests (i.e. measured GFR) should be performed in potential donors whose eGFR is considered borderline, whether eGFR values should be standardized to body surface area, and the outcomes for donors after nephrectomy.

Original languageEnglish (US)
Pages (from-to)188-195
Number of pages8
JournalNephrology Dialysis Transplantation
Volume29
Issue number1
DOIs
StatePublished - 2014

Keywords

  • administrative data
  • glomerular filtration rate
  • kidney transplantation
  • transplant outcomes

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

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