Pre-donation BMI and preserved kidney volume can predict the cohort with unfavorable renal functional compensation at 1-year after kidney donation

Kazunobu Shinoda, Shinya Morita, Hirotaka Akita, Satoshi Tamaki, Ryohei Takahashi, Hidaka Kono, Hiroshi Asanuma, Eiji Kikuchi, Masahiro Jinzaki, Ken Nakagawa, Mototsugu Oya

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Abstract

Background: The magnitude of renal function recovery after kidney donation differs in donors with a heterogeneous background. Preoperative assessment of candidates with potentially unfavorable renal functional compensation is critical when baseline kidney function is marginal. We explored the significance of preserved kidney volume (PKV) and known preoperative risk factors for the prediction of unfavorable renal function compensation. Methods: We enrolled 101 living donors for whom a 1-mm sliced enhanced computed tomography scan was performed preoperatively and clinical data could be collected up to 1 year after donation. The donors whose estimated glomerular filtration rate (eGFR) at 1 year after donation was 70% or higher of baseline eGFR were assigned to the "favorable renal compensation" group and the others to the "unfavorable renal compensation" group. Results: Age, sex, and preoperative serum uric acid level were not significant predictors for "unfavorable renal compensation." Multivariable logistic regression analysis revealed that body mass index (BMI) and body surface area (BSA)-adjusted PKV were independent preoperative risk factors for "unfavorable renal compensation" (adjusted odds ratio, 1.342 and 0.929, respectively). Hypertension and preoperative eGFR were not independent predictors when adjusted with BMI and BSA-adjusted PKV. Receiver operative characteristic analysis revealed that the predictive equation with the two independent predictors yielded a good accuracy to detect donor candidates with unfavorable renal functional compensation (area under the curve = 0.803), and the optimal cut-off values were identified as 23.4 kg/m 2 for BMI and 107.3 cm 3 /m 2 for BSA-adjusted PKV. Conclusions: BMI and BSA-adjusted PKV may be useful to select candidates with potentially unfavorable renal function compensation before kidney donation.

Original languageEnglish
Article number46
JournalBMC Nephrology
Volume20
Issue number1
DOIs
Publication statusPublished - 2019 Feb 8

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Body Mass Index
Kidney
Body Surface Area
Glomerular Filtration Rate
Tissue Donors
Living Donors
Recovery of Function
Uric Acid
Area Under Curve
Logistic Models
Odds Ratio
Tomography
Regression Analysis

Keywords

  • BMI
  • CT volumetry
  • Kidney transplant donor
  • Preserved kidney volume
  • Renal function compensation

ASJC Scopus subject areas

  • Nephrology

Cite this

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title = "Pre-donation BMI and preserved kidney volume can predict the cohort with unfavorable renal functional compensation at 1-year after kidney donation",
abstract = "Background: The magnitude of renal function recovery after kidney donation differs in donors with a heterogeneous background. Preoperative assessment of candidates with potentially unfavorable renal functional compensation is critical when baseline kidney function is marginal. We explored the significance of preserved kidney volume (PKV) and known preoperative risk factors for the prediction of unfavorable renal function compensation. Methods: We enrolled 101 living donors for whom a 1-mm sliced enhanced computed tomography scan was performed preoperatively and clinical data could be collected up to 1 year after donation. The donors whose estimated glomerular filtration rate (eGFR) at 1 year after donation was 70{\%} or higher of baseline eGFR were assigned to the {"}favorable renal compensation{"} group and the others to the {"}unfavorable renal compensation{"} group. Results: Age, sex, and preoperative serum uric acid level were not significant predictors for {"}unfavorable renal compensation.{"} Multivariable logistic regression analysis revealed that body mass index (BMI) and body surface area (BSA)-adjusted PKV were independent preoperative risk factors for {"}unfavorable renal compensation{"} (adjusted odds ratio, 1.342 and 0.929, respectively). Hypertension and preoperative eGFR were not independent predictors when adjusted with BMI and BSA-adjusted PKV. Receiver operative characteristic analysis revealed that the predictive equation with the two independent predictors yielded a good accuracy to detect donor candidates with unfavorable renal functional compensation (area under the curve = 0.803), and the optimal cut-off values were identified as 23.4 kg/m 2 for BMI and 107.3 cm 3 /m 2 for BSA-adjusted PKV. Conclusions: BMI and BSA-adjusted PKV may be useful to select candidates with potentially unfavorable renal function compensation before kidney donation.",
keywords = "BMI, CT volumetry, Kidney transplant donor, Preserved kidney volume, Renal function compensation",
author = "Kazunobu Shinoda and Shinya Morita and Hirotaka Akita and Satoshi Tamaki and Ryohei Takahashi and Hidaka Kono and Hiroshi Asanuma and Eiji Kikuchi and Masahiro Jinzaki and Ken Nakagawa and Mototsugu Oya",
year = "2019",
month = "2",
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doi = "10.1186/s12882-019-1242-0",
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TY - JOUR

T1 - Pre-donation BMI and preserved kidney volume can predict the cohort with unfavorable renal functional compensation at 1-year after kidney donation

AU - Shinoda, Kazunobu

AU - Morita, Shinya

AU - Akita, Hirotaka

AU - Tamaki, Satoshi

AU - Takahashi, Ryohei

AU - Kono, Hidaka

AU - Asanuma, Hiroshi

AU - Kikuchi, Eiji

AU - Jinzaki, Masahiro

AU - Nakagawa, Ken

AU - Oya, Mototsugu

PY - 2019/2/8

Y1 - 2019/2/8

N2 - Background: The magnitude of renal function recovery after kidney donation differs in donors with a heterogeneous background. Preoperative assessment of candidates with potentially unfavorable renal functional compensation is critical when baseline kidney function is marginal. We explored the significance of preserved kidney volume (PKV) and known preoperative risk factors for the prediction of unfavorable renal function compensation. Methods: We enrolled 101 living donors for whom a 1-mm sliced enhanced computed tomography scan was performed preoperatively and clinical data could be collected up to 1 year after donation. The donors whose estimated glomerular filtration rate (eGFR) at 1 year after donation was 70% or higher of baseline eGFR were assigned to the "favorable renal compensation" group and the others to the "unfavorable renal compensation" group. Results: Age, sex, and preoperative serum uric acid level were not significant predictors for "unfavorable renal compensation." Multivariable logistic regression analysis revealed that body mass index (BMI) and body surface area (BSA)-adjusted PKV were independent preoperative risk factors for "unfavorable renal compensation" (adjusted odds ratio, 1.342 and 0.929, respectively). Hypertension and preoperative eGFR were not independent predictors when adjusted with BMI and BSA-adjusted PKV. Receiver operative characteristic analysis revealed that the predictive equation with the two independent predictors yielded a good accuracy to detect donor candidates with unfavorable renal functional compensation (area under the curve = 0.803), and the optimal cut-off values were identified as 23.4 kg/m 2 for BMI and 107.3 cm 3 /m 2 for BSA-adjusted PKV. Conclusions: BMI and BSA-adjusted PKV may be useful to select candidates with potentially unfavorable renal function compensation before kidney donation.

AB - Background: The magnitude of renal function recovery after kidney donation differs in donors with a heterogeneous background. Preoperative assessment of candidates with potentially unfavorable renal functional compensation is critical when baseline kidney function is marginal. We explored the significance of preserved kidney volume (PKV) and known preoperative risk factors for the prediction of unfavorable renal function compensation. Methods: We enrolled 101 living donors for whom a 1-mm sliced enhanced computed tomography scan was performed preoperatively and clinical data could be collected up to 1 year after donation. The donors whose estimated glomerular filtration rate (eGFR) at 1 year after donation was 70% or higher of baseline eGFR were assigned to the "favorable renal compensation" group and the others to the "unfavorable renal compensation" group. Results: Age, sex, and preoperative serum uric acid level were not significant predictors for "unfavorable renal compensation." Multivariable logistic regression analysis revealed that body mass index (BMI) and body surface area (BSA)-adjusted PKV were independent preoperative risk factors for "unfavorable renal compensation" (adjusted odds ratio, 1.342 and 0.929, respectively). Hypertension and preoperative eGFR were not independent predictors when adjusted with BMI and BSA-adjusted PKV. Receiver operative characteristic analysis revealed that the predictive equation with the two independent predictors yielded a good accuracy to detect donor candidates with unfavorable renal functional compensation (area under the curve = 0.803), and the optimal cut-off values were identified as 23.4 kg/m 2 for BMI and 107.3 cm 3 /m 2 for BSA-adjusted PKV. Conclusions: BMI and BSA-adjusted PKV may be useful to select candidates with potentially unfavorable renal function compensation before kidney donation.

KW - BMI

KW - CT volumetry

KW - Kidney transplant donor

KW - Preserved kidney volume

KW - Renal function compensation

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U2 - 10.1186/s12882-019-1242-0

DO - 10.1186/s12882-019-1242-0

M3 - Article

VL - 20

JO - BMC Nephrology

JF - BMC Nephrology

SN - 1471-2369

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M1 - 46

ER -