scholarly journals The evaluation of kidney function in living kidney donor candidates

Kidney360 ◽  
2021 ◽  
pp. 10.34067/KID.0003052021
Author(s):  
Neetika Garg ◽  
Emilio D. Poggio ◽  
Didier Mandelbrot
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Creatinine Clearance ◽  
Kidney Function ◽  
The United States ◽  
Estimated Gfr ◽  
Kidney Donors ◽  
Living Kidney Donors ◽  
Increased Risk ◽  
Measured Gfr

Living kidney donors incur a small increased risk of end-stage kidney disease (ESKD), of which pre-donation glomerular filtration rate (GFR) is an important determinant. As a result, kidney function assessment is central to the donor candidate evaluation and selection process. This article reviews the different methods of GFR assessment including estimated GFR, creatinine clearance and measured GFR, and the current guidelines on GFR thresholds for donor acceptance. Estimated GFR obtained using the 2009 Chronic Kidney Disease Epidemiology Collaboration equation, while the best of estimating estimations, tends to underestimate and has limited accuracy, especially near normal GFR values. In the United States, the Organ Procurement and Transplantation Network policy on living donation mandates either measured GFR or creatinine clearance as part of evaluation. Measured GFR is considered the gold standard, although there is some variation in performance characteristics depending on the marker and technique used. Major limitations of creatinine clearance are dependency on accuracy of timed collection, and overestimation as a result of distal tubular creatinine secretion. GFR declines with healthy aging, and most international guidelines recommend use of age-adapted selection criteria. The 2017 Kidney Disease: Improving Global Outcomes Guideline for the Evaluation and Care of Living Kidney Donors diverges from other guidelines and recommends using absolute cut-off of <60 ml/min/1.73m2 for exclusion and of ≥90 ml/min/1.73m2 for acceptance, and determination of candidacy with intermediate GFR based on long-term ESKD risk. However, several concerns for this strategy exist, including inappropriate acceptance of younger candidates due to underestimation of risk, and exclusion of older candidates whose kidney function is in fact appropriate for age. Role of cystatin C and other newer biomarkers, as well as data on impact of pre-donation GFR on not just ESKD risk but also advanced chronic kidney disease risk and cardiovascular outcomes are needed.

scholarly journals Cystatin-C is associated with partial recovery of kidney function and progression to chronic kidney disease in living kidney donors

Medicine ◽  
2017 ◽  
Vol 96 (5) ◽  
pp. e6037 ◽  
Author(s):  
Ji-Yeon Bang ◽  
Seon-Ok Kim ◽  
Sae-Gyul Kim ◽  
Jun-Gol Song ◽  
Gyu Sam Hwang
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
Cystatin C ◽  
Partial Recovery ◽  
Kidney Donors ◽  
Living Kidney Donors

scholarly journals Kidney Microstructural Features at the Time of Donation Predict Long-term Risk of Chronic Kidney Disease in Living Kidney Donors

2021 ◽  
Vol 96 (1) ◽  
pp. 40-51 ◽  
Author(s):  
Massini A. Merzkani ◽  
Aleksandar Denic ◽  
Ramya Narasimhan ◽  
Camden L. Lopez ◽  
Joseph J. Larson ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Donors ◽  
Living Kidney Donors

scholarly journals Apolipoprotein L1 and Chronic Kidney Disease Risk in Young Potential Living Kidney Donors

2018 ◽  
Vol 267 (6) ◽  
pp. 1161-1168 ◽  
Author(s):  
Jayme E. Locke ◽  
Deirdre Sawinski ◽  
Rhiannon D. Reed ◽  
Brittany Shelton ◽  
Paul A. MacLennan ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Disease Risk ◽  
Kidney Donors ◽  
Living Kidney Donors ◽  
Chronic Kidney Disease Risk ◽  
Apolipoprotein L1

scholarly journals Everyday Discrimination and Kidney Function Among Older Adults: Evidence From the Health and Retirement Study

2019 ◽  
Vol 75 (3) ◽  
pp. 517-521
Author(s):  
Ryon J Cobb ◽  
Roland J Thorpe ◽  
Keith C Norris
Keyword(s):  
Older Adults ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
The United States ◽  
Health And Retirement Study ◽  
Disease Epidemiology ◽  
Lower Egfr ◽  
Everyday Discrimination ◽  
Retirement Study

Abstract Background With advancing age, there is an increase in the time of and number of experiences with psychosocial stressors that may lead to the initiation and/or progression of chronic kidney disease (CKD). Our study tests whether one type of experience, everyday discrimination, predicts kidney function among middle and older adults. Methods The data were from 10 973 respondents (ages 52–100) in the 2006/2008 Health and Retirement Study, an ongoing biennial nationally representative survey of older adults in the United States. Estimated glomerular filtration rate (eGFR) derives from the Chronic Kidney Disease Epidemiology Collaboration equation. Our indicator of everyday discrimination is drawn from self-reports from respondents. Ordinary Least Squared regression (OLS) models with robust standard errors are applied to test hypotheses regarding the link between everyday discrimination and kidney function. Results Everyday discrimination was associated with poorer kidney function among respondents in our study. Respondents with higher everyday discrimination scores had lower eGFR after adjusting for demographic characteristics (B = −1.35, p &lt; .05), and while attenuated, remained significant (B = −0.79, p &lt; .05) after further adjustments for clinical, health behavior, and socioeconomic covariates. Conclusions Our study suggests everyday discrimination is independently associated with lower eGFR. These findings highlight the importance of psychosocial factors in predicting insufficiency in kidney function among middle-aged and older adults.

scholarly journals Sickle Cell Trait and Renal Function in Hispanics in the United States: the Northern Manhattan Study

2017 ◽  
Vol 27 (1) ◽  
pp. 11 ◽  
Author(s):  
Nicole D. Dueker ◽  
David Della-Morte ◽  
Tatjana Rundek ◽  
Ralph L. Sacco ◽  
Susan H. Blanton
Keyword(s):  
United States ◽  
Chronic Kidney Disease ◽  
African Americans ◽  
Kidney Disease ◽  
Sickle Cell ◽  
Sickle Cell Trait ◽  
The United States ◽  
Genetic Mutation ◽  
Single Mutation ◽  
Increased Risk

<p class="Pa7">Sickle cell anemia (SCA) is a common hematological disorder among individu­als of African descent in the United States; the disorder results in the production of abnormal hemoglobin. It is caused by homozygosity for a genetic mutation in HBB; rs334. While the presence of a single mutation (sickle cell trait, SCT) has long been considered a benign trait, recent research suggests that SCT is associated with renal dysfunction, including a decrease in estimated glomerular filtration rate (eGFR) and increased risk of chronic kidney disease (CKD) in African Americans. It is currently unknown whether similar associations are observed in Hispanics. Therefore, our study aimed to determine if SCT is associated with mean eGFR and CKD in a sample of 340 Dominican Hispanics from the Northern Manhattan Study. Using regression analyses, we tested rs334 for association with eGFR and CKD, adjusting for age and sex. eGFR was estimated using the Chronic Kidney Disease Epidemiology Collaboration equa­tion and CKD was defined as eGFR &lt; 60 mL/min/1.73 m2. Within our sample, there were 16 individuals with SCT (SCT carriers). We found that SCT carriers had a mean eGFR that was 12.12 mL/min/1.73m2 lower than non-carriers (P=.002). Additionally, SCT carriers had 2.72 times higher odds of CKD compared with non-carriers (P=.09). Taken together, these novel results show that Hispanics with SCT, as found among African Americans with SCT, may also be at increased risk for kidney disease.</p><p class="Pa7"><em>Ethn Dis. </em>2017; 27(1)<strong>:</strong>11-14; doi:10.18865/ed.27.1.11.</p><p class="Pa7"> </p>

scholarly journals Telomere attrition, kidney function, and prevalent chronic kidney disease in the United States

Oncotarget ◽  
2017 ◽  
Vol 8 (46) ◽  
pp. 80175-80181 ◽  
Author(s):  
Moshen Mazidi ◽  
Peyman Rezaie ◽  
Adriac Covic ◽  
Jolanta Malyszko ◽  
Jacek Rysz ◽  
...  
Keyword(s):  
United States ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
The United States ◽  
Telomere Attrition

Yearly Trends of Chronic Kidney Disease III Progressions in Living Kidney Donors

2019 ◽  
Vol 51 (8) ◽  
pp. 2539-2542
Author(s):  
Hyung Ho Lee ◽  
Joon Chae Na ◽  
Young Eun Yoon ◽  
Hyung Soon Lee ◽  
Kyu Ha Huh ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Donors ◽  
Living Kidney Donors

scholarly journals SAT-329 CORRELATION BETWEEN ESTIMATED GFR AND MEASURED GFR WITH DTPA RENAL SCAN IN LIVING KIDNEY DONORS

2020 ◽  
Vol 5 (3) ◽  
pp. S138
Author(s):  
S. Samavat ◽  
M. Nafar ◽  
S. Hoseinzadeh ◽  
H. Masroor ◽  
N. Dalili MD
Keyword(s):  
Estimated Gfr ◽  
Kidney Donors ◽  
Living Kidney Donors ◽  
Renal Scan ◽  
Measured Gfr

scholarly journals Clonal hematopoiesis of indeterminate potential is associated with worse kidney function and anemia in a cohort of patients with advanced chronic kidney disease

2021 ◽  
Author(s):  
Caitlyn Vlasschaert ◽  
Amy J. M. McNaughton ◽  
Wilma Hopman ◽  
Bryan Kestenbaum ◽  
Cassianne Robinson-Cohen ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
Hematopoietic Stem ◽  
Clonal Hematopoiesis ◽  
Lower Baseline ◽  
Increased Risk ◽  
Aging Populations ◽  
Lower Egfr ◽  
Age And Sex

Background: Clonal hematopoiesis of indeterminate potential (CHIP) is an inflammatory premalignant disorder resulting from acquired genetic mutations in hematopoietic stem cells. CHIP is common in aging populations and associated with cardiovascular morbidity and overall mortality, but its role in chronic kidney disease (CKD) has not been investigated. Methods: We performed targeted sequencing to detect CHIP mutations in a cohort of 87 adults with eGFR < 60 ml/min/1.73m2. Kidney function, hematologic, and mineral bone disease parameters were assessed cross-sectionally at baseline, and a total of 2,091 creatinine measurements and 3,382 hemoglobin measurements were retrospectively collected over the following 12-year period. Results: At baseline, 20 of 87 (23%) cohort participants had CHIP detected. Those with CHIP had lower baseline eGFR (22.3 +/- 11.2 vs. 28.2 +/- 11.5 ml/min/1.73 m2, P = 0.04) in age- and sex-adjusted regression models. Individuals with CHIP had a 2.5-fold increased risk of incident 50% decline in eGFR or ESKD in a Cox proportional hazard model adjusted for age and sex (95% confidence interval, 1.3-4.7). The annualized rate of eGFR decline adjusted for age and sex was -2.3 +/- 1.1 ml/min/1.73m2 per year in those with CHIP versus -1.6 +/- 0.5 ml/min/1.73m2 per year in those without CHIP. Further, those with CHIP had lower hemoglobin at baseline (11.6 +/- 0.3 vs. 12.8 +/- 0.2 g/dL, P = 0.0003) and throughout the follow-up period despite a greater use of erythropoiesis-stimulating agents. Conclusion: In those with pre-existing CKD, CHIP was associated with lower eGFR at baseline, faster progression of CKD, and anemia.

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