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[摘要]：Background. Living kidney transplant donors generally have a favorable renal functional outcome postuninephrectomy, but concern remains that a reduced glomerular filtration rate (GFR) postuninephrectomy might have harmful effects. This study examines the short-term (3 months) effect of donor nephrectomy on GFR and the occurrence of stage 3 chronic kidney disease (CKD) postuninephrectomy.Methods. The prevalence of stage 3CKD(Kidney Disease Quality Outcome Initiative [GFR < 60 mL/min/1.73m(2)]) was examined in 196 living donors by comparing preuninephrectomy and 3-month postuninephrectomy values of GFR using I-125-iothalamate GFR (iGFR), modification of diet in renal disease estimated GFR (eGFR), Cockcroft-Gault estimated creatinine clearance, and endogenous 24-hr creatinine clearance. The accuracy of GFR estimations for predicting iGFR was also studied.Results. The mean GFR before and after donation were iGFR, 105 +/- 18 and 68 +/- 13 mL/min/1.73 m(2); eGFR, 98 +/- 19 and 63 +/- 12 mL/min/1.73m(2); Cockcroft-Gault estimated creatinine clearance, 125 +/- 33 and 85 +/- 22 mL/min/1.73m2, and endogenous 24-hr creatinine clearance, 133 +/- 38 and 86 +/- 24 mL/min/1.73 m2, respectively. Stage 3 CKD was found postuninephrectomy in 53 donors (27%) by iGFR and in 73 donors (38%) by eGFR. The prevalence of stage 3 CKD was greater with older age. GFR estimation equations did not accurately predict iGFR, particularly postuninephrectomy.Conclusions. Stage 3 CKD is commonly observed after living kidney donation, particularly in older donors. The long-term impact of stage 3 CKD postuninephrectomy is poorly understood and may not have the same implications as stage 3 CKD in other conditions. eGFR is a poor predictor of true GFR in kidney donors. |
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