The age-calibrated measured glomerular filtration rate improves living kidney donation selection process

Kidney International
François GaillardChristophe Mariat

Abstract

Recommendations on the glomerular filtration rate (GFR) threshold compatible with living kidney donation are not agreed upon. The recent KDIGO guidelines suggested a reset of the conventional cutoff value of 80 to 90 mL/min/1.73 m2. While GFR physiologically declines with age, it is unclear whether and how age should be taken into account for selecting acceptable pre-donation GFR. In this multicenter retrospective study encompassing 2007 kidney donors in France, we evaluated the impact of age using two threshold measured GFR (mGFR)s (80 and 90 mL/min/1.73 m2). Three groups of donors were defined according to baseline mGFR: below 80, 80-89.9 and 90 mL/min/1.73 m2 or more. Thirty-two percent of donors were selected despite an mGFR below 90 mL/min/1.73 m2. Donors with the lowest mGFR were significantly older (60 ± 9 vs. 47 ± 11 years) and this applied to both male and female donors. The lifetime-standardized renal reserve, defined as the pre-donation mGFR value divided by the expected number of remaining years of life, was similar irrespective of baseline mGFR groups. Similar results were obtained when eGFR was used instead of mGFR. Finally, in a subgroup of 132 donors with repeated mGFR five years after donation, the magnitude of...Continue Reading

Citations

Nov 13, 2018·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Pierre Delanaye
Mar 1, 2019·International Journal of Urology : Official Journal of the Japanese Urological Association·Yoichi KakutaKazunari Tanabe
Feb 26, 2019·Transplantation·François GaillardChristine A White
Dec 14, 2019·Current Opinion in Organ Transplantation·Luuk B Hilbrands
Sep 12, 2019·Journal of the American Society of Nephrology : JASN·Pierre DelanayeJan A J G van den Brand
Jun 6, 2020·Journal of the American Society of Nephrology : JASN·Bjørn O EriksenElke Schaeffner
Apr 2, 2020·Transplantation·Guillaume ClaisseChristophe Mariat
Jan 12, 2021·Progrès en urologie : journal de l'Association française d'urologie et de la Société française d'urologie·J BranchereauM-O Timsit
Mar 29, 2021·Transplant International : Official Journal of the European Society for Organ Transplantation·François GaillardChristophe Mariat
Sep 15, 2021·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Christophe MariatUmberto Maggiore

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