Kidney Week

Abstract: SA-PO973

Evaluation of Renal Functional Reserve in Adult Living Kidney Donors

Session Information

• Transplantation: Clinical - 3
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2102 Transplantation: Clinical

Authors

• Ortega, Jose Luis, Centro Medico Nacional 20 de Noviembre, Mexico City, Mexico

Jose Luis Ortega, MD

• Alamilla-Sanchez, Mario, Centro Medico Nacional 20 de Noviembre, Mexico City, Mexico

Mario Alamilla-Sanchez, MD, MSc

• Morales Lopez, Enrique Fleuvier, Centro Medico Nacional 20 de Noviembre, Mexico City, Mexico

Enrique Fleuvier Morales Lopez

• Rosillo-Salgado, Ydris Zelim, Centro Medico Nacional 20 de Noviembre, Mexico City, Mexico

Ydris Zelim Rosillo-Salgado, MD

• Torres Cuevas, Jose Luis, Centro Medico Nacional 20 de Noviembre, Mexico City, Mexico

Jose Luis Torres Cuevas, MD

• Gonzalez-Fuentes, Carolina, Centro Medico Nacional 20 de Noviembre, Mexico City, Mexico

Carolina Gonzalez-Fuentes, MD, MSc

• Ulloa Galvan, Victor Manuel, Centro Medico Nacional 20 de Noviembre, Mexico City, Mexico

Victor Manuel Ulloa Galvan, MD

• Rubio, Jesús Omar, Centro Medico Nacional 20 de Noviembre, Mexico City, Mexico

Jesús Omar Rubio, MD

• Carbajal, Martin Omar, Centro Medico Nacional 20 de Noviembre, Mexico City, Mexico

Martin Omar Carbajal, MEd, ScD

Background

Renal functional reserve (RFR) assessed by renal response to a protein load is considered to reflect functional reserve capacity and is believed to be a tool for screening living donors

Methods

A descriptive, observational and prospective study was carried out in a single center where 22 living kidney donors, over 18 years of age, clinically healthy, were considered between the month of July 2023 to May 2024. RFR was measured with a test of the glomerular stress using an oral protein loading test

Results

Of a total of 22 patients included, the median age was 39 (18-56) years, 77% (17) women. Body mass index was 25.5 (20.2 to 32.7). Median baseline Cr was 0.67 (0.47-1.04) mg/dl, median baseline cystatin was 0.67 (0.40-0.9) mg/dl versus post-cystatin. stress was 0.6 (0.30-0.90) mg/dl. The median values of bGFR and sGFR were statistically different (123.54 [56.38 -250.11] vs. 178.71 [84.88 - 418.43] ml/min/1.73 m2, p = 0. 0017. A difference will be observed between bGFR and sGFR, with an RFR = 45.9% (11.87-132.62) equivalent to an increase in GFR after a protein load of 48.81 ml/min (16.24- 161.56) having a bGFR > 90 ml/min was associated with a risk of presenting borderline FRR < 30). ml/min OR 1.2 95% CI (1.0- 1.05) and a BMI < 30 estimated an OR 0.76 95% CI (0.60-0.96) protective factor to preserve an RFR > 30ml /min.

Conclusion

The results suggest that glomerular renal stress testing by oral protein loading could be useful before transplantation to establish the original global filtration capacity of the donor kidneys. The results provide a previous global renal function of 48 ml/min, a result similar to that reported in the literature, drawing attention to the tendency in obese patients to present a low RFR, as well as the no association in the level of basal normality. creatines and RFR that may represent an inadequate estimate and present the patient's susceptibility to developing kidney injury before it becomes clinically evident