Prediction model of compensation for contralateral kidney after living-donor donation
Abstract Background Compensation of contralateral kidney function after living-donor kidney donation is well known, and many predictive factors have been proposed. However, no prediction model has been proposed. This study was performed to establish a tool with which to estimate the degree of compen...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-07-01
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| Series: | BMC Nephrology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12882-019-1464-1 |
| _version_ | 1819078740245741568 |
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| author | Kenji Okumura Shigeyoshi Yamanaga Kosuke Tanaka Kohei Kinoshita Akari Kaba Mika Fujii Masatomo Ogata Yuji Hidaka Mariko Toyoda Soichi Uekihara Akira Miyata Akito Inadome Hiroshi Yokomizo |
| author_facet | Kenji Okumura Shigeyoshi Yamanaga Kosuke Tanaka Kohei Kinoshita Akari Kaba Mika Fujii Masatomo Ogata Yuji Hidaka Mariko Toyoda Soichi Uekihara Akira Miyata Akito Inadome Hiroshi Yokomizo |
| author_sort | Kenji Okumura |
| collection | DOAJ |
| description | Abstract Background Compensation of contralateral kidney function after living-donor kidney donation is well known, and many predictive factors have been proposed. However, no prediction model has been proposed. This study was performed to establish a tool with which to estimate the degree of compensation of the contralateral kidney after living-donor kidney donation. Methods We retrospectively analyzed 133 living donors for renal transplantation in our institution. We defined a favorable compensation as a post-donation estimated glomerular filtration rate (eGFR) at 1 year (calculated by the Chronic Kidney Disease Epidemiology Collaboration equation) of > 60% of the pre-donation eGFR. We analyzed the living donors’ clinical characteristics and outcomes. Results The median (range) donor age was 59 (24–79) years, median (range) body mass index was 22.9 (16.8–32.7) kg/m2, and median (range) body surface area was 1.6 (1.3–2.0) m2. All donors were Japanese, and 73% of the donors were biologically related. The median (range) donor pre-donation eGFR was 108.7 (82–144) ml/min/1.73 m2, and the median (range) post-donation eGFR at 1 year was 86.9 (43–143) ml/min/1.73 m2. Eighty-six percent of donors had compensatory hypertrophy. In the univariate analysis, age, female sex, history of hypertension, body surface area, and pre-donation eGFR were significantly associated with hypertrophy (p < 0.05). In the multivariate analysis, age, female sex, history of hypertension, and ratio of the remnant kidney volume to body weight were significantly associated with hypertrophy (p < 0.05). Based on these results, we created a compensation prediction score (CPS). The median (range) CPS was 8.7 (1.1–17.4). Receiver operating characteristic analysis showed strong diagnostic accuracy for predicting favorable compensation (area under the curve, 0.958; 95% confidence interval, 0.925–0.991, p < 0.001). The optimal cut-off value of the CPS was 5.0 (sensitivity, 92.0%; specificity, 89.5%). The CPS had a strong positive correlation with the post-donation eGFR (R = 0.797, p < 0.001). Conclusion The CPS might be useful tool with which to predict a favorable compensation of the contralateral kidney and remnant kidney function. If the CPS is low, careful management and follow-up might be necessary. Further investigations are needed to validate these findings in larger populations. |
| first_indexed | 2024-12-21T19:17:54Z |
| format | Article |
| id | doaj.art-b4ecfeaf0bda45d2a0e03e5e0f532c7f |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-12-21T19:17:54Z |
| publishDate | 2019-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-b4ecfeaf0bda45d2a0e03e5e0f532c7f2022-12-21T18:53:01ZengBMCBMC Nephrology1471-23692019-07-012011510.1186/s12882-019-1464-1Prediction model of compensation for contralateral kidney after living-donor donationKenji Okumura0Shigeyoshi Yamanaga1Kosuke Tanaka2Kohei Kinoshita3Akari Kaba4Mika Fujii5Masatomo Ogata6Yuji Hidaka7Mariko Toyoda8Soichi Uekihara9Akira Miyata10Akito Inadome11Hiroshi Yokomizo12Department of Surgery, Japanese Red Cross Kumamoto HospitalDepartment of Surgery, Japanese Red Cross Kumamoto HospitalDepartment of Surgery, Japanese Red Cross Kumamoto HospitalDepartment of Surgery, Japanese Red Cross Kumamoto HospitalDepartment of Surgery, Japanese Red Cross Kumamoto HospitalDepartment of Nephrology, Japanese Red Cross Kumamoto HospitalDepartment of Nephrology, Japanese Red Cross Kumamoto HospitalDepartment of Surgery, Japanese Red Cross Kumamoto HospitalDepartment of Nephrology, Japanese Red Cross Kumamoto HospitalDepartment of Nephrology, Japanese Red Cross Kumamoto HospitalDepartment of Nephrology, Japanese Red Cross Kumamoto HospitalDepartment of Urology, Japanese Red Cross Kumamoto HospitalDepartment of Surgery, Japanese Red Cross Kumamoto HospitalAbstract Background Compensation of contralateral kidney function after living-donor kidney donation is well known, and many predictive factors have been proposed. However, no prediction model has been proposed. This study was performed to establish a tool with which to estimate the degree of compensation of the contralateral kidney after living-donor kidney donation. Methods We retrospectively analyzed 133 living donors for renal transplantation in our institution. We defined a favorable compensation as a post-donation estimated glomerular filtration rate (eGFR) at 1 year (calculated by the Chronic Kidney Disease Epidemiology Collaboration equation) of > 60% of the pre-donation eGFR. We analyzed the living donors’ clinical characteristics and outcomes. Results The median (range) donor age was 59 (24–79) years, median (range) body mass index was 22.9 (16.8–32.7) kg/m2, and median (range) body surface area was 1.6 (1.3–2.0) m2. All donors were Japanese, and 73% of the donors were biologically related. The median (range) donor pre-donation eGFR was 108.7 (82–144) ml/min/1.73 m2, and the median (range) post-donation eGFR at 1 year was 86.9 (43–143) ml/min/1.73 m2. Eighty-six percent of donors had compensatory hypertrophy. In the univariate analysis, age, female sex, history of hypertension, body surface area, and pre-donation eGFR were significantly associated with hypertrophy (p < 0.05). In the multivariate analysis, age, female sex, history of hypertension, and ratio of the remnant kidney volume to body weight were significantly associated with hypertrophy (p < 0.05). Based on these results, we created a compensation prediction score (CPS). The median (range) CPS was 8.7 (1.1–17.4). Receiver operating characteristic analysis showed strong diagnostic accuracy for predicting favorable compensation (area under the curve, 0.958; 95% confidence interval, 0.925–0.991, p < 0.001). The optimal cut-off value of the CPS was 5.0 (sensitivity, 92.0%; specificity, 89.5%). The CPS had a strong positive correlation with the post-donation eGFR (R = 0.797, p < 0.001). Conclusion The CPS might be useful tool with which to predict a favorable compensation of the contralateral kidney and remnant kidney function. If the CPS is low, careful management and follow-up might be necessary. Further investigations are needed to validate these findings in larger populations.http://link.springer.com/article/10.1186/s12882-019-1464-1Kidney transplant donorRenal function compensationCT volumetryRemnant kidney volume |
| spellingShingle | Kenji Okumura Shigeyoshi Yamanaga Kosuke Tanaka Kohei Kinoshita Akari Kaba Mika Fujii Masatomo Ogata Yuji Hidaka Mariko Toyoda Soichi Uekihara Akira Miyata Akito Inadome Hiroshi Yokomizo Prediction model of compensation for contralateral kidney after living-donor donation BMC Nephrology Kidney transplant donor Renal function compensation CT volumetry Remnant kidney volume |
| title | Prediction model of compensation for contralateral kidney after living-donor donation |
| title_full | Prediction model of compensation for contralateral kidney after living-donor donation |
| title_fullStr | Prediction model of compensation for contralateral kidney after living-donor donation |
| title_full_unstemmed | Prediction model of compensation for contralateral kidney after living-donor donation |
| title_short | Prediction model of compensation for contralateral kidney after living-donor donation |
| title_sort | prediction model of compensation for contralateral kidney after living donor donation |
| topic | Kidney transplant donor Renal function compensation CT volumetry Remnant kidney volume |
| url | http://link.springer.com/article/10.1186/s12882-019-1464-1 |
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