COMMENTARY TO CONTROVERSIES IN NEPHROLOGY

Utility of Estimated Glomerular Filtration Rate in Live Kidney Donation

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

¹ To whom correspondence should be addressed. E-mail: rparasu1{at}hfhs.org.

	Abstract

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.