External Validation of a Predictive Model to Estimate Renal Function After Living Donor Nephrectomy

Abstract

Supplemental Digital Content is available in the text.

External Validation of the Toulouse-Rangueil Predictive Model to Estimate Donor Renal Function After Living Donor Nephrectomy

“…In this study, the predictive model developed at Toulouse-Rangueil (11) was validated externally in our cohort of living kidney donors in concordance with other external validation studies in different European populations (12,13). A significant correlation was observed between calculated and observed 1-year eGFR (Pearson r = 0.67), and for the prediction of CKD (eGFR values < 60 mL/min/ 1.73 m 2 ) at 1 year after donation, the model presented an AUROC of 0.83, which represents an excellent performance.…”

“…A significant correlation was observed between calculated and observed 1-year eGFR (Pearson r = 0.67), and for the prediction of CKD (eGFR values < 60 mL/min/ 1.73 m 2 ) at 1 year after donation, the model presented an AUROC of 0.83, which represents an excellent performance. Benoit et al (13), in a population of 400 French living donors that performed nephrectomy at Necker Hospital, also described a significant correlation between predicted and observed 1-year eGFR (Pearson r = 0.66), and for the prediction of CKD at 1 year, the model presented an AUROC of 0.86. We must emphasize that the optimal value of predicted eGFR was around 5 mL/min higher than the equality cutoff for CKD detection at 1 year, an outcome that was correctly predicted (both its presence and absence) in every 3 out of 4 donors.…”

“…In this study, changes in eGFR after donation varied by sex, percent decline in eGFR within the first 6 weeks after donation, and eGFR category at 1 year, but not by age category at donation, pre- donation hypertension, pre-donation eGFR category, socioeconomic status, or distance to transplant center (18). Be it as it may, the predictive model developed from the Toulouse-Rangueil cohort unquestionably showed a good correlation between predicted and observed donor eGFR 1-year after donation in 3 different centers (11)(12)(13). These results, along with the fact that donor age was found to be a strong predictor of CKD after LDKT, may defer the wish to extend, without fair criticism, the age limit of donors, which has been advocated to expand the pool (19,20).…”

“…A formula using multiple linear regression was designed for clinical application and the authors described a good statistical performance (11). This model was then externally validated in a German center by Kullik et al (12) and in a different French cohort (13) and was shown to have a good correlation to the observed 1-year postdonation eGFR.…”

Predicting Kidney Function 1 Year After Nephrectomy in Living Kidney Donor Candidates

“…In this issue of Transplantation , Benoit et al 6 have improved our understanding of the performance of an equation that can be used in the predonation period to estimate GFR 1 y after donation: postoperative eGFR = 31.71 + (0.521 × preoperative eGFR) − (0.314 × age in years at donation). They studied 400 of 630 donors at a single-center in Paris, France who underwent nephrectomy over a 12-y period (2006–2018).…”