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Predictive model of 1-year postoperative renal function after living donor nephrectomy

  • Urology - Original Paper
  • Published:
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Abstract

Objective

Kidney transplantation from a living donor nephrectomy (LDN) is the best treatment for end-stage renal disease, but decrease in donor renal function is often revealed. The aim of this study was to evaluate the association between preoperative factors and postoperative estimated glomerular filtration rate (eGFR) and test a predictive model to estimate postoperative eGFR, 1 year after LDN.

Patients and methods

We reviewed 226 records of consecutive patients who underwent laparoscopic live donor nephrectomy between 2006 and 2014 in a single tertiary center. Of these, complete data on 202 patients were analyzed. A training (2/3 of the whole population) and a validation set (1/3) were randomized. A multivariate regression model was used to identify predictors and a formula to estimate of 1-year postoperative eGFR in the training set, using the CKD-EPI formula. Then, the formula was subjected to internal validation using the validation set using receiver operating characteristic (ROC) curves.

Results

Two hundred and two LLDN were evaluated with a mean preoperative eGFR of 94.1 ± 15.5 ml/min/1.73 m2 and postoperative eGFR of 64.6 ± 14.5 ml/min/1.73 m2 (p < 0.0001). In multivariable analysis, age and preoperative eGFR were independent predictors of postoperative eGFR in the training set. A formula to estimate postoperative eGFR was generated with Pearson r = 0.70 in the training cohort and 0.65 in the validation cohort (both p < 0.0001). Area under the ROC curve of the formula was 0.89 in the training cohort and 0.83 in the validation cohort (both p < 0.0001).

Conclusions

Preoperative eGFR and age are predictors of postoperative eGFR after LDN. The internally validated predictive model of postoperative eGFR developed could be an accurate tool to improve the selection of LDN candidates.

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Abbreviations

ESRD:

End-stage renal disease

LDN:

Living donor nephrectomy (LDN)

eGFR:

Estimated glomerular filtration rate

CKD:

Chronic kidney disease

BMI:

Body mass index

ASA:

American Society of Anaesthesiologists

CKD-EPI:

Chronic Kidney Disease Epidemiology Collaboration Formula

ROC:

Receiver operating curves

AUC:

Areas under the curve

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Authors and Affiliations

  1. Department of Urology, Andrology and Transplantation, Centre Hospitalier universitaire Toulouse-Rangueil, 1 avenue du Pr Jean Poulhes, 31059, Toulouse Cedex 9, France

    Thibaut Benoit, Xavier Game, Mathieu Roumiguie, Federico Sallusto, Nicolas Doumerc, Jean Baptiste Beauval, Pascal Rischmann, Michel Soulie & Bernard Malavaud

  2. Department of Nephrology and Transplantation, Centre Hospitalier universitaire Toulouse-Rangueil, Toulouse, France

    Nassim Kamar

Authors
  1. Thibaut Benoit
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  2. Xavier Game
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  3. Mathieu Roumiguie
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Correspondence to Thibaut Benoit.

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All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional review board and with the 1964 Helsinki Declaration.

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Informed consent was obtained from all individual participants included in the study.

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Benoit, T., Game, X., Roumiguie, M. et al. Predictive model of 1-year postoperative renal function after living donor nephrectomy. Int Urol Nephrol 49, 793–801 (2017). https://doi.org/10.1007/s11255-017-1559-1

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  • DOI: https://doi.org/10.1007/s11255-017-1559-1

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