ArticleWorld journal of urology2025
Impact of donating the larger kidney by CT volumetry on the kidney function, 5-years after living donation.
Article in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
purposeRemoving the smaller kidney for donor nephrectomy has been advocated if there is a size difference of ≥ 10% after other anatomical considerations. This study reports the difference in long-term renal function in patients who have their larger kidney removed for donor nephrectomy.
methodsData of 104 donors were prospectively collected. They were divided into 2 groups depending on donated kidney being ≥ 10% larger (Group-1) or < 10% larger (Group-2) than the remaining kidney. Baseline characteristics (age, gender, BMI, surgical details, co-morbidities), estimated Glomerular Filtration Rate (eGFR, calculated using CKD-EPI formula) before and up to 5-years after surgery were collected.
resultsGroup 1 (n = 28) and Group 2 (n = 76) had similar baseline characteristics. The split renal volume (SRV) of donated kidney was 53.4% (52.5-58.7%) for Group 1 and 49.9% (44.3-52.5%) for Group 2 eGFR between 2 groups were similar (110.7 ± 20.8 vs 103.4 ± 22.5, p = 0.14). eGFR was not different at 6-months, 1-, 3- and 5-year post-operation. Patients with eGFR < 60 was also not significantly different between the 2 groups 23.1% vs 31.4% (p = 0.42). Group-1 had significantly greater absolute reduction in eGFR than Group-2 (45.5 ± 17.8 vs 37.6 ± 14.5, p = 0.02) at 6-months post op. After which, there was a steady improvement in eGFR up to 5-years; which was most significant from the 6-months to 1-year (p = 0.02, 0.001). The absolute and relative recovery in eGFR beyond 6-months does not differ significantly.
conclusionDespite an initial greater decrease in eGFR at 6 months, removing the larger kidney (> 10% absolute difference within the SRV limits of this study) for donor nephrectomy did not result in a significant difference in kidney function at 5 years due to similar rates of eGFR recovery after nadir levels at 6 months.
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