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Published ahead of print on October 22, 2008
Clin J Am Soc Nephrol 3: 1608-1609, 2008
© 2008 American Society of Nephrology
doi: 10.2215/CJN.04840908
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Commentaries in Response to Controversies in Nephrology

Utility of Estimated Glomerular Filtration Rate in Live Kidney Donation

Ravi Parasuraman, and K. K. Venkat

Division of Nephrology and Hypertension, Henry Ford Hospital, Detroit, Michigan

Correspondence: Dr. Ravi Parasuraman, Medical Director, Kidney Transplant Program, Henry Ford Hospital, CFP-2, 2799 West Grand Boulevard, Detroit, MI 48202. Phone: 313-916-9405; Fax: 313-916-2554; E-mail: rparasu1{at}hfhs.org

Live kidney donation is considered safe; nevertheless, data supporting such claims are almost exclusively of white origin with very limited long-term outcomes in ethnic minority donors. This prospective observational study consisted of a total of 103 previous kidney donors (54 black and 49 white) with mean follow-up days of 743.5 ± 603.9 for white and 845.1 ± 668.5 for black donors. The black donors had a statistically significant greater loss of estimated GFR (eGFR; 39.8 ml/min per 1.73 m2) in comparison with white donors (30.4 ml/min per 1.73 m2; P = 0.001). In multivariate analysis, predonation eGFR of <100 ml/min and age at the time of donation were the significant predictors for postdonation eGFR <60 ml/min among black donors. Because eGFR using the Modification of Diet in Renal Disease 4 formula is not validated in live kidney donors, the significance of eGFR <60 ml/min per 1.73 m2 in previous kidney donors is unclear. Long-term prospective study with a gold standard method such as iothalamate GFR measurement is needed to define the actual decrease in eGFR after kidney donation.






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