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The 1-year decline in estimated glomerularfiltration rate (eGFR) after radical nephrectomyin patients with renal masses and matched living

kidney donors is the sameMiki N. Hew, Dedan Opondo, Ernesto R. Cordeiro, Karlijn A.M.I.van Donselaar-van der Pant*, Frederike J. Bemelman*, Mirza M. Idu*,Jean J.M.C.H. de la Rosette* and M. Pilar Laguna*

Department of Urology, *Renal Transplant Unit, Department of Internal Medicine, and Department of Surgery,Academisch Medisch Centrum, Amsterdam, The Netherlands

Objectives To determine short-term differences in renal function

evolution between patients with renal cell carcinoma (RCC)submitted to radical nephrectomy (RN) and living kidneydonors matched for age and gender.

To assess the role of co-morbidity as a risk factor fordeveloping an estimated glomerular filtration rate (eGFR) of

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The fact that donor selection is primarily based on good healthand limited co-morbidity, has been the advocated reason [6].

By contrast, Timsit et al. [8] reported that donors and patientswith RCC with a low co-morbidity load presented with thesame percentage of decrease in renal function at 14 yearsafter RN, despite the patients RCC being older and havinglower baseline renal function.

The primary objective of the present study was to determineshort-term differences in renal function evolution betweenpatients with RCC submitted to RN and living kidney donorsat an age when RCC is predominant. The secondary objectivewas to assess the role of co-morbidity as a risk factor fordeveloping an eGFR of

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The 1-year postoperative eGFR in patients with RCC wasdistributed as follows:90 mL/min/1.73 m2 in four (4.5%);

6089 mL/min/1.73 m2 in 29 (32.6%); 3059 mL/min/1.73 m2in 52 (58.4%) and 1529 mL/min/1.73 m2 in four (4.5%)patients. In the donor group, at 1 year 33 donors (37.9%) hadan eGFR of 6089 mL/min/1.73 m2 and 54 (62.1%) had aneGFR of 3059 mL/min/1.73 m2 (P= 0.04). No patient in thedonor group developed an eGFR of

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Univariate analyses showed significant associations betweendeveloping an eGFR of

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were traditionally considerably lower than the correspondingfigures in patients with RCC. In older living donors, with amean age in the range of our RCC cohort, a similar eGFRdecrease has been reported [15,16]. Renal function decline inprevious studies seemed to be dependent on age at donation[3,12]. It was more prominent in donors aged60 years than

in younger ones. Up to 80% of the elderly might develop apost-RN eGFR of

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collect follow-up data and rates of an eGFR of

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26 Lamb EJ, Tomson CR, Roderick PJ.Estimating kidney function in adults

using formulae.Ann Clin Biochem2005; 42: 32145

Correspondence:M. Pilar Laguna, Academisch MedischCentrum, G4 dep. of Urology, Meibergdreef 9, Postbus 22660,1100 DD Amsterdam, The Netherlands.

e-mail:m.p.lagunapes@amc.uva.nl

Abbreviations:BMI, body mass index; CKD, chronic kidneydisease; CVD, cardiovascular disease; eGFR, estimated GFR;MDRD, Modification in Diet and Renal Disease; NSS,nephron-sparing surgery; OR, odds ratio; RN, radicalnephrectomy.

Co-morbidity and eGFR after RN in donors and patients with RCC

2013 The AuthorsBJU International 2013 BJU International E55