Introduction: Following nephrectomy for the purpose of kidney donation, the donor has an inevitably reduced renal mass and function. Living kidney donors exhibit a higher risk of end stage renal disease, but the absolute risk is low.
Aims: To assess the changes in glomerular filtration rate (GFR) after living donation, and assess the parameters associated with it.
Background: A retrospective analysis was conducted at the Tel Aviv Medical Center. It included all living donors who donated a kidney between January 2000 to June 2019 in our center, and had at least one follow-up visit during the first year.
Results: In a mean follow-up period of 7.9 ± 6.1 years, none of the 365 donors has reached eGFR<30 ml/min/m2, and 74.3% had a GFR>60 ml/min/m2 on the last day of follow-up. Older age, male sex and baseline kidney function were associated with a reduced kidney function (eGFR<60) and a higher reduction of eGFR after donation. In addition, mean systolic and diastolic blood pressure and urine albumin excretion were significantly elevated following donation. However, they were not related to eGFR post donation.
Conclusions: Kidney donation is associated with an excellent long-term outcome. The mean reduction in GFR post donation is 25% of baseline levels, and is related to advanced age, sex and pre-donation GFR. Future studies are needed to explore whether changes in blood pressure, albumin excretion and GFR are associated with long term outcomes, similar to the general population.