The Ultrasound Renal Stress Test for the Assessment of Functional Renal Reserve in Kidney Transplantation: A Pilot Study in Living Donors
In the evolving landscape of nephrology and kidney transplants, assessing renal functional reserve (RFR) in living kidney donors is essential for ensuring donor safety and successful transplantation. This study explores the use of the Intra-Parenchymal Renal Resistive Index Variation (IRRIV) test, a...
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MDPI AG
2024-01-01
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author | Federico Nalesso Francesca K. Martino Marco Bogo Elisabetta Bettin Marianna Alessi Lucia F. Stefanelli Cristina Silvestre Lucrezia Furian Lorenzo A. Calò |
author_facet | Federico Nalesso Francesca K. Martino Marco Bogo Elisabetta Bettin Marianna Alessi Lucia F. Stefanelli Cristina Silvestre Lucrezia Furian Lorenzo A. Calò |
author_sort | Federico Nalesso |
collection | DOAJ |
description | In the evolving landscape of nephrology and kidney transplants, assessing renal functional reserve (RFR) in living kidney donors is essential for ensuring donor safety and successful transplantation. This study explores the use of the Intra-Parenchymal Renal Resistive Index Variation (IRRIV) test, a novel non-invasive method, to measure RFR in living donors. Our observational study included 11 participants undergoing living kidney donations, evaluated using the IRRIV-based Renal Stress Test (RST) before and 12 months post-nephrectomy. The study demonstrated significant changes in creatinine and eGFR CKD-EPI levels post-donation, with an average creatinine rise from 69 to 97 µmol/L and a reduction in eGFR from 104 to 66 mL/min/1.73 m<sup>2</sup>. These variations align with the expected halving of nephron mass post-nephrectomy and the consequent recruitment of RFR and hyperfiltration in the remaining nephrons. This pilot study suggests that the IRRIV-based RST is a practical, safe, and reproducible tool, potentially revolutionizing the assessment of RFR in living kidney donors, with implications for broader clinical practice in donor eligibility evaluation, even in borderline renal cases. Furthermore, it confirms the feasibility of RST in living kidney donors and allows us to assess the sample size in 48 donors for a future study. |
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issn | 2077-0383 |
language | English |
last_indexed | 2024-03-08T09:51:47Z |
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spelling | doaj.art-4690052a845e44c2a6b1edfba127f4862024-01-29T14:02:40ZengMDPI AGJournal of Clinical Medicine2077-03832024-01-0113252510.3390/jcm13020525The Ultrasound Renal Stress Test for the Assessment of Functional Renal Reserve in Kidney Transplantation: A Pilot Study in Living DonorsFederico Nalesso0Francesca K. Martino1Marco Bogo2Elisabetta Bettin3Marianna Alessi4Lucia F. Stefanelli5Cristina Silvestre6Lucrezia Furian7Lorenzo A. Calò8Department of Medicine, Nephrology-Dialysis-Kidney Transplant Unit, University of Padua, 35128 Padua, ItalyDepartment of Medicine, Nephrology-Dialysis-Kidney Transplant Unit, University of Padua, 35128 Padua, ItalyDepartment of Medicine, Nephrology-Dialysis-Kidney Transplant Unit, University of Padua, 35128 Padua, ItalyDepartment of Medicine, Nephrology-Dialysis-Kidney Transplant Unit, University of Padua, 35128 Padua, ItalyDepartment of Medicine, Nephrology-Dialysis-Kidney Transplant Unit, University of Padua, 35128 Padua, ItalyDepartment of Medicine, Nephrology-Dialysis-Kidney Transplant Unit, University of Padua, 35128 Padua, ItalyDepartment of Surgical Oncological and Gastroenterological Sciences, Kidney and Pancreas Transplant Unit, University of Padua, 35128 Padua, ItalyDepartment of Surgical Oncological and Gastroenterological Sciences, Kidney and Pancreas Transplant Unit, University of Padua, 35128 Padua, ItalyDepartment of Medicine, Nephrology-Dialysis-Kidney Transplant Unit, University of Padua, 35128 Padua, ItalyIn the evolving landscape of nephrology and kidney transplants, assessing renal functional reserve (RFR) in living kidney donors is essential for ensuring donor safety and successful transplantation. This study explores the use of the Intra-Parenchymal Renal Resistive Index Variation (IRRIV) test, a novel non-invasive method, to measure RFR in living donors. Our observational study included 11 participants undergoing living kidney donations, evaluated using the IRRIV-based Renal Stress Test (RST) before and 12 months post-nephrectomy. The study demonstrated significant changes in creatinine and eGFR CKD-EPI levels post-donation, with an average creatinine rise from 69 to 97 µmol/L and a reduction in eGFR from 104 to 66 mL/min/1.73 m<sup>2</sup>. These variations align with the expected halving of nephron mass post-nephrectomy and the consequent recruitment of RFR and hyperfiltration in the remaining nephrons. This pilot study suggests that the IRRIV-based RST is a practical, safe, and reproducible tool, potentially revolutionizing the assessment of RFR in living kidney donors, with implications for broader clinical practice in donor eligibility evaluation, even in borderline renal cases. Furthermore, it confirms the feasibility of RST in living kidney donors and allows us to assess the sample size in 48 donors for a future study.https://www.mdpi.com/2077-0383/13/2/525renal functional reserve (RFR)living kidney donationIntra-Parenchymal RenalResistive Index Variation (IRRIV)Renal Stress Test (RST)nephrectomy |
spellingShingle | Federico Nalesso Francesca K. Martino Marco Bogo Elisabetta Bettin Marianna Alessi Lucia F. Stefanelli Cristina Silvestre Lucrezia Furian Lorenzo A. Calò The Ultrasound Renal Stress Test for the Assessment of Functional Renal Reserve in Kidney Transplantation: A Pilot Study in Living Donors Journal of Clinical Medicine renal functional reserve (RFR) living kidney donation Intra-Parenchymal Renal Resistive Index Variation (IRRIV) Renal Stress Test (RST) nephrectomy |
title | The Ultrasound Renal Stress Test for the Assessment of Functional Renal Reserve in Kidney Transplantation: A Pilot Study in Living Donors |
title_full | The Ultrasound Renal Stress Test for the Assessment of Functional Renal Reserve in Kidney Transplantation: A Pilot Study in Living Donors |
title_fullStr | The Ultrasound Renal Stress Test for the Assessment of Functional Renal Reserve in Kidney Transplantation: A Pilot Study in Living Donors |
title_full_unstemmed | The Ultrasound Renal Stress Test for the Assessment of Functional Renal Reserve in Kidney Transplantation: A Pilot Study in Living Donors |
title_short | The Ultrasound Renal Stress Test for the Assessment of Functional Renal Reserve in Kidney Transplantation: A Pilot Study in Living Donors |
title_sort | ultrasound renal stress test for the assessment of functional renal reserve in kidney transplantation a pilot study in living donors |
topic | renal functional reserve (RFR) living kidney donation Intra-Parenchymal Renal Resistive Index Variation (IRRIV) Renal Stress Test (RST) nephrectomy |
url | https://www.mdpi.com/2077-0383/13/2/525 |
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