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. 2021 Jun;34(6):1123-1133.
doi: 10.1111/tri.13870. Epub 2021 May 20.

Living kidney donor evaluation for all candidates with normal estimated GFR for age

François Gaillard  1 , Lola Jacquemont  2 , Hélène Lazareth  3 , Laetitia Albano  4 , Benoit Barrou  5 , Nicolas Bouvier  6 , Mathias Buchler  7 , Dimitri Titeca-Beauport  8 , Lionel Couzi  9 , Michel Delahousse  10 , Didier Ducloux  11 , Isabelle Etienne  12 , Luc Frimat  13 , Cyril Garrouste  14 , Denis Glotz  15 , Philippe Grimbert  16 , Marc Hazzan  17 , Alexandre Hertig  18 , Maryvonne Hourmant  2 , Nassim Kamar  19 , Yann Le Meur  20 , Moglie Le Quintrec  21 , Christophe Legendre  22 , Valérie Moal  23 , Bruno Moulin  24 , Christiane Mousson  25 , Claire Pouteil-Noble  26 , Philippe Rieu  27 , Nacera Ouali  28 , Lionel Rostaing  29 , Antoine Thierry  30 , Fatouma Toure  31 , Jonathan Chemouny  32 , Pierre Delanaye  33   34 , Marie Courbebaisse  35 , Christophe Mariat  36
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Free article

Living kidney donor evaluation for all candidates with normal estimated GFR for age

François Gaillard et al. Transpl Int. 2021 Jun.
Free article

Abstract

Multiple days assessments are frequent for the evaluation of candidates to living kidney donation, combined with an early GFR estimation (eGFR). Living kidney donation is questionable when eGFR is <90 ml/min/1.73 m2 (KDIGO guidelines) or 80 ml/min/1.73 m2 (most US centres). However, age-related GFR decline results in a lower eGFR for older candidates. That may limit the number of older kidney donors. Yet, continuing the screening with a GFR measure increases the number of eligible donors. We hypothesized that in-depth screening should be proposed to all candidates with a normal eGFR for age. We compared the evolution of eGFR after donation between three groups of predonation eGFR: normal for age (Sage ) higher than 90 or 80 ml/min/1.73 m2 (S90 and S80, respectively); across three age groups (<45, 45-55, >55 years) in a population of 1825 French living kidney donors with a median follow-up of 5.9 years. In donors younger than 45, postdonation eGFR, absolute- and relative-eGFR variation were not different between the three groups. For older donors, postdonation eGFR was higher in S90 than in S80 or Sage but other comparators were identical. Postdonation eGFR slope was comparable between all groups. Our results are in favour of in-depth screening for all candidates to donation with a normal eGFR for age.

Keywords: age; estimated GFR; living kidney donors; post-donation GFR; screening.

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