Mid-Term Results of Renal Function in Living Kidney Donors in a Single Center

Abstract

Objective: Living donor nephrectomy (LDN) has been described as a safe operation with low morbidity and mortality rates. The aim of the study was to evaluate the differences between preoperative and postoperative renal functions in LDN and to identify risk factors predicting possible long-term persistent renal dysfunction.

Methods: Donors who underwent LDN operations in our center between April 2019 and January 2023 were evaluated retrospectively. Demographic characteristics, renal function tests, routine blood and urine tests, post-transplant complications, ultrasonographic kidney size measurement, and control parameters 1 year after the operation were compared. Factors affecting renal function at 1-year postdonation were analyzed.

Results: A total of 110 who met the inclusion criteria were included. Fifty-eight donors (52.7%) were male, and the mean age was 46.54 ± 12.18 years. During follow-up, kidney size of donors increased significantly 1 year after nephrectomy (109.38 ± 9.70 vs 115.65 ± 11.58 mm, P = .001), and estimated glomerular filtration ratio (e-GFR) values were decreased significantly (107.83 ± 13.72 vs 75.68 ± 17.14 mL/min/1.73 m², P < .001). The urine protein creatinine ratio (PCR) was found to be significantly increased (157.6 ± 89.6 vs 206.6 ± 147.2 g/g, P = .001). Although within normal values, there was a significant increase in serum creatinine levels (P < .001), thyroid stimulating hormone (TSH) (P = .050), and serum potassium (P < .001) levels in one year after donation. The increase rates in serum creatinine after 1 year of follow-up were more significant in male gender and in individuals over 50 years of age (P = .016 and P = .006, respectively).

Conclusion: Although renal dysfunction may occur when well-selected donors remain with a single kidney after LDN, long-term outcomes are safe and may carry tolerable minor risks.