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The importance of kidney volume as a marker in the assessment of living-donor kidney transplantation in Japan

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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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Abbreviations

ESKD:

End-stage kidney disease

RFR:

Renal functional reserve

GFR:

Glomerular filtration rate

PKV:

Preserved kidney volume

CKD:

Chronic kidney disease

CT:

Computed tomography

Cre:

Creatinine

BSA:

Body surface area

HT:

Hypertension

HLP:

Hyperlipidemia

DM:

Diabetes mellitus

HbA1c:

Hemoglobin A1c

eGFRcre:

Estimated creatinine-based GFR

eGFRcys:

Estimated cystatin C-based GFR

eGFRave:

Averaged value of eGFRcre and eGFRcys

BP:

Blood pressure

BMI:

Body mass index

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Acknowledgements

We sincerely thank all the staff of the Kidney Disease Center at Nagoya Daini Red Cross Hospital for their cooperation with this study.

Funding

None.

Author information

Authors and Affiliations

  1. Department of Kidney Transplantation, Masuko Memorial Hospital, 35-28 Takebashi-cho, Nakamura-ku, Nagoya, 453-8566, Japan

    Makoto Tsujita, Kazuharu Uchida & Kunio Morozumi

  2. Department of Kidney Disease Center, Transplant Nephrology and Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan

    Makoto Tsujita, Norihiko Goto, Kenta Futamura, Manabu Okada, Takahisa Hiramitsu, Shunji Narumi & Yoshihiko Watarai

Authors
  1. Makoto Tsujita
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  2. Norihiko Goto
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  3. Kenta Futamura
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  4. Manabu Okada
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  5. Takahisa Hiramitsu
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  6. Shunji Narumi
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  7. Kazuharu Uchida
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  8. Kunio Morozumi
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  9. Yoshihiko Watarai
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Contributions

MT: research idea and study design, data acquisition, data interpretation, statistical analysis, and wrote manuscript. NG: data acquisition. KF: data acquisition. MO: data acquisition. TH: data acquisition. NS: data acquisition. KU: supervision. KM: supervision. YW: data acquisition and supervision.

Corresponding author

Correspondence to Makoto Tsujita.

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Conflict of interest

The authors have declared that no conflict of interest exists.

Research involving human and animal rights

This study was performed per the Declaration of Helsinki, and the Ethics Committee approved the research protocol of the Nagoya Daini Red Cross Hospital Research Institute (Approval no. 1329). Because of a retrospective cohort study, informed consent from individual participants was waived.

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Tsujita, M., Goto, N., Futamura, K. et al. The importance of kidney volume as a marker in the assessment of living-donor kidney transplantation in Japan. Clin Exp Nephrol 25, 537–544 (2021). https://doi.org/10.1007/s10157-020-02014-3

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  • DOI: https://doi.org/10.1007/s10157-020-02014-3

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