Evaluation of Renal Function and Other Relevant Parameters in Living Kidney Donors after Nephrectomy

Background: Kidney transplantation, especially from a living donor, is a preferred treatment for many with chronic kidney disease (CKD). Unilateral nephrectomy reduces total glomerular filtration rate (GFR), impacting kidney function, arterial hypertension, proteinuria, and other biochemical issues. Evaluation and follow-up of donors are crucial. This study aimed to evaluate the renal function and other relevant parameters in living kidney donors after nephrectomy.

Methods: This prospective, observational was conducted in the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from January 2017 to August 2018. A total of 25 adult patients who underwent donor nephrectomy were purposively enrolled as study subjects. Data were analyzed using SPSS version 23.0.

Results: Participants' serum creatinine levels significantly (p<0.05) rose at 1-, 3-, 6-, and 12-months post-surgery compared to baseline. Both 24-hour creatinine clearance and eGFR significantly (p<0.05) decreased at 1, 3, 6, and 12 months after surgery. GFR was notably (p<0.05) lower at 6- and 12-months post-surgery. Conversely, 24-hour urinary total protein (UTP) levels significantly (p<0.05) increased at 1, 3, 6, and 12 months after surgery. From baseline to 12 months’ post-donation, serum intact parathyroid hormone and uric acid levels were notably (p<0.05) higher, while hemoglobin, serum calcium, serum phosphorus, and serum albumin levels were significantly (p<0.05) lower. Kidney size showed significant (p<0.05) increases at 1-, 3-, 6-, and 12-months post-surgery.

Conclusion: Living kidney donors may experience a mild decline in glomerular filtration rate (GFR) and biochemical changes following nephrectomy. However, short-term follow-up suggests that outcomes of kidney donation appear safe. Nevertheless, it's crucial to monitor living kidney donors for potential adverse outcomes of donation.