Assessment of the Renal Function in Potential Donors of Living Kidney Transplants: Expanded Study

Macias, Lidia; Poblet, Marta Suñer; Pérez, Nathasha Nava; Jerez, R. Iglesias; Roncero, Francisco González; Blanco, G. Bernal; Pérez-Valdivia, M.Á.; Benjumea, Alejandro Suárez; Govantes, M.A. Gentil

doi:10.1016/j.transproceed.2015.09.029

Cited by 8 publications

(6 citation statements)

References 12 publications

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“…Despite the demographic similarity between patients with stages 4 and 5 CKD and stage 3 CKD, the renal outcomes and the hospital course of the stage 4 and 5 CKD+ patients were significantly worse compared with the stage 3 CKD+ patients, with the exception of the severity of their renal function (Table ) and extent of their ascites (Table ). These patients also had more organ failures (Table ), which was associated with lower 30‐ and 90‐day overall survival (Fig. ).…”

Section: Resultsmentioning

confidence: 99%

“…As a result of more frequent AKI episodes, significantly more CKD+ patients required initiation of renal replacement therapy (Table ). In addition, more CKD+ patients developed other organ failures (circulatory, brain, and respiratory failures as per NASCELD ACLF criteria), and hence more CKD+ patients required admission into intensive care units (ICUs), which was associated with significantly more prolonged hospital stays. Despite the demographic similarity between patients with stages 4 and 5 CKD and stage 3 CKD, the renal outcomes and the hospital course of the stage 4 and 5 CKD+ patients were significantly worse compared with the stage 3 CKD+ patients, with the exception of the severity of their renal function (Table ) and extent of their ascites (Table ).…”

Section: Resultsmentioning

confidence: 99%

“…The MDRD–6 variable formula was not used because blood urea nitrogen was not uniformly collected. Furthermore, we preferred the MDRD4 formula to the Chronic Kidney Disease Epidemiology Collaboration (CKD‐Epi) formula because the MDRD4 formula seems to approximate closer to the real GFR than the CKD‐Epi formula, especially in patients with low GFR. Data collected included patient demographics, past medical history, medication use, vital signs, baseline full blood count, biochemistry, liver and renal functions, and details of any infection.…”

Section: Methodsmentioning

confidence: 99%

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Impact of Chronic Kidney Disease on Outcomes in Cirrhosis

Wong

Reddy

O’Leary³

et al. 2019

Liver Transpl

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We hypothesize that the prevalence of chronic kidney disease (CKD) among patients with cirrhosis has increased due to the increased prevalence of CKD‐associated comorbidities, such as diabetes. We aimed to assess the characteristics of hospitalized patients with cirrhosis with CKD and its impact on renal and patient outcomes. The North American Consortium for the Study of End‐Stage Liver Disease (NACSELD) prospectively enrolled nonelectively admitted patients with cirrhosis and collected data on demographics, laboratory results, in‐hospital clinical course, and postdischarge 3‐month outcomes. CKD positive (CKD+) patients, defined as having an estimated glomerular filtration rate (eGFR; Modification of Diet in Renal Disease–4 variable formula) of ≤60 mL/minute for >3 months, were compared with chronic kidney disease negative (CKD–) patients for development of organ failures, hospital course, and survival. There were 1099 CKD+ patients (46.8% of 2346 enrolled patients) who had significantly higher serum creatinine (2.21 ± 1.33 versus 0.83 ± 0.21 mg/dL in the CKD– group) on admission, higher prevalence of nonalcoholic steatohepatitis cirrhosis etiology, diabetes, refractory ascites, and hospital admissions in the previous 6 months compared with the CKD– group (all P < 0.001). Propensity matching (n = 922 in each group) by Child‐Pugh scores (9.78 ± 2.05 versus 9.74 ± 2.04, P = 0.70) showed that CKD+ patients had significantly higher rates of superimposed acute kidney injury (AKI; 68% versus 21%; P < 0.001) and eventual need for dialysis (11% versus 2%; P < 0.001) than CKD– patients. CKD+ patients also had more cases of acute‐on‐chronic liver failure as defined by the NACSELD group, which was associated with reduced 30‐ and 90‐day overall survival (P < 0.001 for both). A 10 mL/minute drop in eGFR was associated with a 13.1% increase in the risk of 30‐day mortality. In conclusion, patients with CKD should be treated as a high‐risk group among hospitalized patients with cirrhosis due to their poor survival, and they should be monitored carefully for the development of superimposed AKI.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Impact of Chronic Kidney Disease on Outcomes in Cirrhosis

Wong

Reddy

O’Leary³

et al. 2019

Liver Transpl

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“…In January 2000, HALDN procedures were performed at our institution for technical convenience and were subsequently modified into other methods. Hospital records for donors were reviewed for the following data parameters: operative time, body mass index (BMI), age, sex, laterality, hospital length of stay (LOS), warm ischemia time, pre-operative estimated glomerular filtration rate (eGFR), postoperative eGFR [12], and incision length. The Clavien-Dindo classification system was used as a reference to identify and grade donor complications [13].…”

Section: Methodsmentioning

confidence: 99%

Evolution of Laparoscopic Donor Nephrectomy Techniques and Outcomes: A Single-Center Experience with More than 1000 Cases

et al. 2020

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Departmental sources Background: Laparoscopic donor nephrectomy (LDN) has evolved and has been established as a surgical standard of care for kidney transplantation. Material/Methods: This study retrospectively reviews 1132 patients who underwent 4 different laparoscopic living-donor nephrectomies: hand-assisted laparoscopic nephrectomy (HALDN), pure laparoscopic donor nephrectomy (PLDN), laparoendoscopic single-site plus 1-port donor nephrectomy (LESSOP-DN), and mini laparoscopic donor nephrectomy (MLDN). Results: The mean estimated blood loss (EBL) for the HALDN group was meaningfully higher than those of LESSOP-DN and MLDN (57.5±52.2 mL versus 21.0±30.0 mL versus 18.2±28.7 mL) (P<0.001). The EBL for PLDN (53.3±35.3 mL) was also significantly higher than those of LESSOP-DN and MLDN (P<0.001). Length of stay (LOS) for HALDN was longer than that for LESSOP-DN (4.2±1.2 day versus 4.0±1.4 days, P=0.002). There was 1 intraoperative open conversion in the HALDN group and 2 HALDN surgeries that required postoperative exploratory laparotomy. LESSOP-DN had 3 (0.8%) postoperative incisional hernias. For recipients, the results revealed no significant differences between all 4 groups in terms of estimated glomerular filtration rate (eGFR) and the 1-year graft failure rate. Conclusions: The LESSOP-DN group was associated with a shorter incision length than those of HALDN and PLDN and shorter LOS than that of HALDN. Recipient results showed no meaningful difference regarding laparoscopic donor nephrectomy technique.

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“…Measuring creatinine clearance (CrCl) by means of 24-hour urine collection is an alternative when exogenous filtration markers are not available [ 3 ]. However, CrCl may be affected by overestimation or underestimation due to errors in urine collection as well as from the tubular secretion of creatinine [ 3 – 8 ].…”

Section: Introductionmentioning

confidence: 99%

Creatinine clearance in selection of living kidney donor among the Malaysian population: is it safe?

Thye,

Lee,

Jalalonmuhali

et al. 2023

BMC Nephrol

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Background Assessment of donor renal function is made by the measurement of Glomerular Filtration Rate (GFR). Exogenous markers are preferred over creatinine clearance and are widely used for measuring GFR. However, they are difficult to obtain, costly and laborious. This is a study to look into the safety and accuracy of creatinine clearance for renal assessment among the living kidney donors in the Malaysian population. Methods This is a retrospective, single-centre study comprising 105 living kidney donor candidates from the year 2007 to 2020. By comparing against 51-Chromium ethylenediamine-tetraacetic acid (51Cr-EDTA), we analysed creatinine clearance for correlation, bias, precision and accuracy. Results The study group had a mean age of 45.68 ± 10.97 years with a mean serum creatinine of 64.43 ± 17.68 µmol/L and a urine volume of 2.06 ± 0.83 L. Mean measured GFR from 51Cr-EDTA was 124.37 ± 26.83 ml/min/1.73m2 whereas mean creatinine clearance was 132.35 ± 38.18 ml/min/1.73m2. Creatinine clearance overestimated 51Cr-EDTA significantly with a correlation coefficient of 0.48 (p < 0.001) and an accuracy of 78.10% and 64.0% within 30% and 20% respectively of 51Cr-EDTA. Conclusion Creatinine clearance is an acceptable and affordable alternative for donor renal assessment in the absence of exogenous markers with an emphasis on adequate urine collection followed by using measured GFR in selected cases.

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Assessment of the Renal Function in Potential Donors of Living Kidney Transplants: Expanded Study

Cited by 8 publications

References 12 publications

Impact of Chronic Kidney Disease on Outcomes in Cirrhosis

Impact of Chronic Kidney Disease on Outcomes in Cirrhosis

Evolution of Laparoscopic Donor Nephrectomy Techniques and Outcomes: A Single-Center Experience with More than 1000 Cases

Creatinine clearance in selection of living kidney donor among the Malaysian population: is it safe?

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