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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Main Authors: Federico Nalesso, Francesca K. Martino, Marco Bogo, Elisabetta Bettin, Marianna Alessi, Lucia F. Stefanelli, Cristina Silvestre, Lucrezia Furian, Lorenzo A. Calò
Format: Article
Language:English
Published: MDPI AG 2024-01-01
Series:Journal of Clinical Medicine
Subjects:
Online Access:https://www.mdpi.com/2077-0383/13/2/525
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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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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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