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Introduction <p>Some living kidney donors (LKDs) experience proteinuria after donation. Based on several studies, preoperative non-donated side kidney volume (pre-KV) and postoperative percentage change in preserved kidney hypertrophy (%PKH) are associated with proteinuria. This study explored the association of the combination of pre-KV and %PKH with new-onset proteinuria.</p> Methods <p>This single-center, retrospective, observational study included eligible LKDs who underwent donor nephrectomy between January 2008 and July 2022 (<i>N</i> = 195). Among those, LKDs in whom KV and either urinary protein or albumin were obtained both pre-donation and 1&#xa0;year post-donation were finally included (<i>N</i> = 70). The LKDs were assigned to four groups according to the mean body surface area-adjusted pre-KV and %PKH, and their association with the occurrence of proteinuria or albuminuria was investigated.</p> Results <p>Among the 70 LKDs, mean age was 59.8 ± 7.9&#xa0;years, and 50 (71.4%) were females. The mean preoperative estimated glomerular filtration rate, %PKH, and pre-KV was 78.0 ± 13.6&#xa0;mL/min/1.73&#xa0;m<sup>2</sup>, 20.3 ± 7.0%, and 161.4 ± 24.1&#xa0;cm<sup>3</sup>/1.73&#xa0;m<sup>2</sup>, respectively. During the 2.4&#xa0;year follow-up period, there was no significant difference in the occurrence of proteinuria among the four groups (log-rank test, <i>P</i> = 0.111). However, after adjustment, the large pre-KV and small %PKH group had a significantly higher hazard ratio (HR) for proteinuria than the small pre-KV and large %PKH groups (adjusted HR 3.12, 95% confidence interval: 1.09–8.91, <i>P</i> = 0.033).</p> Conclusions <p>Proteinuria is more likely to occur postoperatively in LKDs whose kidneys are already enlarged before donation and cannot appropriately hypertrophy.</p>

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Relationship between new-onset proteinuria and the volume of the non-donated kidney before and after donation in living kidney donors

  • 期刊论文

  • 发表日期：

    2025年2月12日

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  • Masatomo Ogata,
  • Takamasa Miyauchi,
  • Kiyomi Osako,
  • Naohiko Imai,
  • Yuko Sakurai,
  • Kazunobu Shinoda,
  • Yugo Shibagaki,
  • Masahiko Yazawa

摘要

Introduction

Some living kidney donors (LKDs) experience proteinuria after donation. Based on several studies, preoperative non-donated side kidney volume (pre-KV) and postoperative percentage change in preserved kidney hypertrophy (%PKH) are associated with proteinuria. This study explored the association of the combination of pre-KV and %PKH with new-onset proteinuria.

Methods

This single-center, retrospective, observational study included eligible LKDs who underwent donor nephrectomy between January 2008 and July 2022 (N = 195). Among those, LKDs in whom KV and either urinary protein or albumin were obtained both pre-donation and 1 year post-donation were finally included (N = 70). The LKDs were assigned to four groups according to the mean body surface area-adjusted pre-KV and %PKH, and their association with the occurrence of proteinuria or albuminuria was investigated.

Results

Among the 70 LKDs, mean age was 59.8 ± 7.9 years, and 50 (71.4%) were females. The mean preoperative estimated glomerular filtration rate, %PKH, and pre-KV was 78.0 ± 13.6 mL/min/1.73 m2, 20.3 ± 7.0%, and 161.4 ± 24.1 cm3/1.73 m2, respectively. During the 2.4 year follow-up period, there was no significant difference in the occurrence of proteinuria among the four groups (log-rank test, P = 0.111). However, after adjustment, the large pre-KV and small %PKH group had a significantly higher hazard ratio (HR) for proteinuria than the small pre-KV and large %PKH groups (adjusted HR 3.12, 95% confidence interval: 1.09–8.91, P = 0.033).

Conclusions

Proteinuria is more likely to occur postoperatively in LKDs whose kidneys are already enlarged before donation and cannot appropriately hypertrophy.