Predictors of low estimated glomerular filtration rate after living kidney donation in a Southeast Asian population from Singapore

AimPost-donation kidney function has not been well characterized in the Southeast Asian population. We studied a retrospective cohort of 174 living kidney donors at Singapore General Hospital between 1976 and 2012, evaluated patterns of change in kidney function using quantile regression analysis and investigated for predictors of low estimated glomerular filtration rate (eGFR)<60mL/min per 1.73m(2). Median follow-up time (range) was 7.8 (0.1-33.8) years following donor nephrectomy. ResultsOf the donors, 43.1% regained 75% or more of pre-nephrectomy eGFR after 5 years post-donation; 9.8% exhibited 100% recovery to pre-nephrectomy eGFR. High pre-nephrectomy eGFR was protective for risk of low post-donation eGFR, with a 6% risk reduction for each unit increase in pre-nephrectomy eGFR (odds ratio, 0.94; 95% confidence interval, 0.91-0.97; P=0.002). This relationship was stronger in the short term (>6months to<5years) than medium to long term (5years or longer) (interaction P=0.052). ConclusionIn general, kidney function is well preserved following kidney donation in Southeast Asian donors. Pre-nephrectomy eGFR is a good predictor of post-donation eGFR, especially in the short-term. Summary at a Glance This is a long-term follow-up study of South-East Asian donors from a single-centre in Singapore, evaluating the association between pre-donation factors and post-donation kidney function.