Donor Evaluation of Living Kidney Transplantation in the Aging Society.


Journal

Nephron
ISSN: 2235-3186
Titre abrégé: Nephron
Pays: Switzerland
ID NLM: 0331777

Informations de publication

Date de publication:
2023
Historique:
received: 08 12 2022
accepted: 23 06 2023
medline: 15 11 2023
pubmed: 24 8 2023
entrez: 23 8 2023
Statut: ppublish

Résumé

Because of the lack of organ donation, living kidney transplantation (LKT) is increasing worldwide. Recently, the number of elderly donors has been increasing, and the patients with end-stage kidney diseases are older than those in the previous decades. Due to the advanced ages, their glomerular filtration rates (GFR) decrease, and the comorbidities such as hypertension, diabetic condition, and obesity are common. The clinicians now have to give their unwilling consent to the LKT from the donors with expanded criteria. For the secure selection of donors, proper GFR measuring is essential. Although directly measured GFR (mGFR) was recommended in the guidelines, estimated GFR (eGFR) is used at the initial evaluation of donor renal function clinically. Many equations calculating eGFR have been published so far. In the selection of eGFR equations, the smaller difference between mGFR and eGFR and the closer relationship to the prevalence rates of comorbidities are requisite points. Therefore, we compared the specificity of the various eGFR equations. The eGFR calculated from the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation showed approximate reliability with minimal difference between mGFR and eGFR and the closer relationships to the prevalence rates of comorbidities. The CKD-EPI-eGFR presented optimal performance in the donor renal function evaluation. Therefore, eGFR from the CKD-EPI equation is highly recommended in evaluating renal function in LKT donors.

Sections du résumé

BACKGROUND BACKGROUND
Because of the lack of organ donation, living kidney transplantation (LKT) is increasing worldwide. Recently, the number of elderly donors has been increasing, and the patients with end-stage kidney diseases are older than those in the previous decades. Due to the advanced ages, their glomerular filtration rates (GFR) decrease, and the comorbidities such as hypertension, diabetic condition, and obesity are common. The clinicians now have to give their unwilling consent to the LKT from the donors with expanded criteria.
SUMMARY CONCLUSIONS
For the secure selection of donors, proper GFR measuring is essential. Although directly measured GFR (mGFR) was recommended in the guidelines, estimated GFR (eGFR) is used at the initial evaluation of donor renal function clinically. Many equations calculating eGFR have been published so far. In the selection of eGFR equations, the smaller difference between mGFR and eGFR and the closer relationship to the prevalence rates of comorbidities are requisite points. Therefore, we compared the specificity of the various eGFR equations. The eGFR calculated from the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation showed approximate reliability with minimal difference between mGFR and eGFR and the closer relationships to the prevalence rates of comorbidities.
KEY MESSAGE CONCLUSIONS
The CKD-EPI-eGFR presented optimal performance in the donor renal function evaluation. Therefore, eGFR from the CKD-EPI equation is highly recommended in evaluating renal function in LKT donors.

Identifiants

pubmed: 37611543
pii: 000531915
doi: 10.1159/000531915
doi:

Substances chimiques

Creatinine AYI8EX34EU

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

61-66

Informations de copyright

© 2023 S. Karger AG, Basel.

Auteurs

Shinichi Nishi (S)

Division of Nephrology and Kidney Center, Graduate School of Medicine, Kobe University, Kobe, Japan.

Shunsuke Goto (S)

Division of Nephrology and Kidney Center, Graduate School of Medicine, Kobe University, Kobe, Japan.

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Classifications MeSH