Background
Compensation of contralateral kidney function after living-donor kidney donation is well known, and many predictive factors have been proposed. However, no prediction model has been proposed. This study was performed to establish a tool with which to estimate the degree of compensation of the contralateral kidney after living-donor kidney donation.
Methods
We retrospectively analyzed 133 living donors for renal transplantation in our institution. We defined a favorable compensation as a post-donation estimated glomerular filtration rate (eGFR) at 1 year (calculated by the Chronic Kidney Disease Epidemiology Collaboration equation) of > 60% of the pre-donation eGFR. We analyzed the living donors’ clinical characteristics and outcomes.
Results
The median (range) donor age was 59 (24–79) years, median (range) body mass index was 22.9 (16.8–32.7) kg/m
2
, and median (range) body surface area was 1.6 (1.3–2.0) m
2
. All donors were Japanese, and 73% of the donors were biologically related. The median (range) donor pre-donation eGFR was 108.7 (82–144) ml/min/1.73 m
2
, and the median (range) post-donation eGFR at 1 year was 86.9 (43–143) ml/min/1.73 m
2
. Eighty-six percent of donors had compensatory hypertrophy. In the univariate analysis, age, female sex, history of hypertension, body surface area, and pre-donation eGFR were significantly associated with hypertrophy (
p
< 0.05). In the multivariate analysis, age, female sex, history of hypertension, and ratio of the remnant kidney volume to body weight were significantly associated with hypertrophy (
p
< 0.05). Based on these results, we created a compensation prediction score (CPS). The median (range) CPS was 8.7 (1.1–17.4). Receiver operating characteristic analysis showed strong diagnostic accuracy for predicting favorable compensation (area under the curve, 0.958; 95% confidence interval, 0.925–0.991,
p
< 0.001). The optimal cut-off value of the CPS was 5.0 (sensitivity, 92.0%; specificity, 89.5%). The CPS had a strong positive correlation with the post-donation eGFR (R = 0.797,
p
< 0.001).
Conclusion
The CPS might be useful tool with which to predict a favorable compensation of the contralateral kidney and remnant kidney function. If the CPS is low, careful management and follow-up might be necessary. Further investigations are needed to validate these findings in larger populations.
Abstract. The purpose of this study was to come across an exercise that increases the Hamstring contraction levels so that it may protect the anterior cruciate ligament (ACL). Previous studies have postulated that changing the projection of the center of gravity behind the feet will decrease the translation of the tibia, therefore protect the ACL. Muscle activity of the quadriceps, hamstring and soleus muscles in healthy subjects was measured with an EMG during three different squat tasks with differences of support of body weight and the center of gravity. The subjects were nine healthy female recreational athletes with no history of any pathological knee condition or musculoskeletal system disorder. There was no significant difference in the activities of the four muscles (Vastus Medialis; Hamstring: Semitendinosus and Biceps Femoris; and Soleus); and there was a similar pattern in the activity between those muscles in the exercises. In addition, VM values were considerably higher than the Hamstring and soleus activity levels. There was no significant difference between one squat from another and among the phases (0-30°, 30-60° or 60-90°) of knee flexion. These results suggest that even when changing the projection of the center of gravity, the activity of the quadriceps is high compared to the hamstring and soleus muscles.
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