The Impact of Living Kidney Donor Glomerular Filtration Rate on Graft Survival
Abstract
1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Parameter | No Graft Loss (n = 214) | Graft Loss Is Present (n = 15) | p |
---|---|---|---|
Recipient gender, female/male (%) | 87/127 (40.7%) | 3/12 (20%) | 0.113 a |
Recipient age | 35 (18–69) | 25 (18–63) | 0.084 b |
Recipient BMI, kg/m2 | 22.6 (15.8–39.8) | 21.3 (16.8–26.1) | 0.076 b |
Induction | |||
No | 11 (5.1%) | 0 (0%) | 0.129 a |
Simulect | 52 (24.3%) | 7 (46.7%) | |
Anti-thymocyte globulin (ATG) | 151 (70.6%) | 8 (53.3%) | |
Creatinine at discharge (mg/dL) | 1.09 (0.45–5.2) | 1.16 (0.65–6.58) | 0.438 b |
GFR at discharge (mL/dk/1.73 mL2) | 83.7 ± 24.2 | 82.9 ± 39.9 | 0.941 c |
Tacrolimus, yes/no (yes %) | 210/4 (98.1%) | 14/1 (93.3%) | 0.753 |
Mycofenolat mofetil (MMF), yes/no (yes %) | 115/99 (53.7%) | 11/4 (73.3%) | 0.140 |
Mycopheloic acid (MYF), yes/no (yes %) | 96/118 (44.9%) | 4/11 (26.7%) | 0.170 |
Final creatinine | 1.14 (0.54–4.1) | 6.1 (1.76–12.2) | <0.001 b |
Final GFR | 72 (14–135) | 11 (5–51) | <0.001 b |
Greft biopsy, yes/no (%) | 42/172 (19.6%) | 11/4 (73.3%) | <0.001 a |
Biopsy result | |||
Normal | 11 (%26.8) | 0 (%0) | |
Rejection | 16 (%39) | 7 (%63.6) | 0.288 a |
BK virus-associated Nephropathy(BKVAN) | 2 (%4.9) | 1 (%9.1) | |
GN | 7 (%17.1) | 1 (%9.1) | |
Chronic allograft nephropathy(CAN) | 5 (%12.2) | 2 (%18.2) | |
Recipient blood group | |||
0 | 61 (28.5%) | 6 (40%) | |
A | 83 (38.8%) | 3 (20%) | 0.250 a |
B | 52 (24.3%) | 3 (20%) | |
AB | 18 (8.4%) | 3 (20%) | |
Time spent on dialysis, months | 2 (0–240) | 8 (0–120) | 0.286 b |
Preemptive, Yes/No (%) | 84/130 (539.3) | 5/10 (33.3%) | 0.649 a |
Number of HLA mismatches | 3 (0–6) | 3 (0–6) | 0.696 b |
Primary kidney disease | |||
DN | 40 (18.7%) | 1 (6.7%) | |
HT | 14 (6.5%) | 0 (0%) | |
GN | 19 (8.9%) | 2 (13.3%) | |
Obstructive pathologies | 19 (8.9%) | 1 (6.7%) | 0.477 a |
PKD | 3 (1.4%) | 0 (0%) | |
TIN | 5 (2.3%) | 0 (0%) | |
Amyloidosis | 4 (1.9%) | 0 (0%) | |
Hereditary | 2 (0.9%) | 1 (6.7%) | |
Unknown etiologies | 108 (50.5%) | 10 (66.7%) | |
Pre-tranplantation | |||
recipient HT, Yes/No (%) | 56/158 (26.2%) | 9/6 (60%) | 0.005 a |
DM | 12/2022 (5.6%) | 0/15 (0%) | 0.346 a |
Coronary artery disease(CAD) | 13/201 (6.1%) | 2/13 (13.3%) | 0.256 a |
Post-transplantation | |||
HT, Yes/No (%) | 150/64 (70.1%) | 13/2 (86.7%) | 0.171 a |
DM | 47/167 (22%) | 2/13 (13.3%) | 0.431 a |
Coronary artery disease(CAD) | 13/201 (6.1%) | 2/13 (13.3%) | 0.256 a |
Median follow up duration, months | 65.9 (1–136) | 55.6 (5.7–123.5 | 0.981 |
Mortality rate | 11/203 (5.1%) | 4/11 (26.7%) | 0.001 a |
Parameter | No Graft Loss (n = 214) | Graft Loss Is Present (n = 15) | p |
---|---|---|---|
Donor gender, female/male (%) | 135/79 (63.1%) | 11/4 (73.3%) | 0.425 a |
Donor age | 43 (22–74) | 47 (21–62) | 0.348 b |
Donor BMI, kg/m2 | 26.3 (16.6–39.5) | 26,8 (19.9–38) | 0.609 b |
Pre-transplantation donor HT Yes/No (%) | 13/204 (6%) | 2/13 (13.3%) | 0.251 |
Pre-transplantation donor CAD Yes/No (%) | 5/212 (2.3%) | 1/14 (6.7%) | 0.850 |
Donor operation type | |||
Open nephrectomy | 90 (42.1%) | 60 (40%) | 0.876 a |
Laparoscopic nephrectomy | 124 (57.9%) | 9 (60%) | |
Kidney removed left/right (%left) | 142/72 (%66.4) | 13/2 (86.7%) | 0.104 a |
Number of arteries | 1 (1–3) | 1 (1–2) | 0.760 b |
Donor GFR, mL/min/1.73 m2 | 111.3 ± 11.5 | 106.3 ± 10.7 | 0.108 c |
Donor blood group | |||
O | 112 (52.3%) | 7 (46.7%) | |
A | 58 (27.1%) | 4 (26.7%) | 0.196 a |
B | 38 (17.8%) | 2 (13.3%) | |
AB | 6 (2.8%) | 2 (13.3%) |
Recipients’ Post-Transplant Discharge Creatinine | Recipients’ Post-Transplant Discharge GFR | Recipients’ Final Creatinin | Recipients’ Final GFR | ||
---|---|---|---|---|---|
Donor eGFR | Correlation Coefficient (r) | −0.219 * | 0.255 * | −0.240 * | 0.302 * |
p | 0.001 | <0.001 | <0.001 | <0.001 |
Univariate Logistic Regression | Multivariate Logistic Regression | |||||
---|---|---|---|---|---|---|
CI (%95) | OR | p | RR CI (%95) | OR | p | |
Recipient characteristic | ||||||
Gender | Referance male | |||||
0.100–1.331 | 0.365 | 0.127 | ||||
Age | 0.921–1.013 | 0.966 | 0.149 | |||
BMI | 0.747–1.007 | 0.867 | 0.062 | |||
Induction | ||||||
No | Referance | Referance | ||||
Simulect | 0.000 | 0.000 | 0.999 | 0.000 | 949 | 0.999 |
ATG | 0.878–7.350 | 2.541 | 0.085 | 0.000 | 2087 | 0.999 |
Pre-transplatation HT | 1.441–12.425 | 4.232 | 0.009 | 1.937–28.882 | 7.479 | 0.004 |
Post-transplantation HT | 0.608–12.645 | 2.773 | 0.188 | |||
CAD | 0.485–11.675 | 2.379 | 0.286 | |||
Graft biopsy | 3.416–37.132 | 11.262 | <0.001 | 5.387–113.609 | 24.74 | <0.001 |
Donor characteristics | ||||||
Kidney side | ||||||
left | Referance | |||||
right | 0.067–1.381 | 0.303 | 0.123 | |||
Blood group | ||||||
O | Referance | Referance | ||||
A | 0.310–3.924 | 1.103 | 0.879 | 0.269–5.342 | 1.199 | 0.812 |
B | 0.168–4.230 | 0.842 | 0.835 | 0.060–4.638 | 0.527 | 0.564 |
AB | 0.906–31.410 | 5.333 | 0.064 | 0.987–83.106 | 9.055 | 0.051 |
GFR | 0.918–1.009 | 0.962 | 0.089 | 0.870–0.983 | 0.925 | 0.013 |
Male Recipient | p | Female Recipient | p | p * | |||
---|---|---|---|---|---|---|---|
Recipient Characteristic | Female Donor | Male Donor | Male Donor | Female Donor | |||
Age | 37 (18–66) | 31 (18–58) | 0.152 | 37.5 (18–69) | 31 (18–59) | 0.008 | 0.023 |
Recipient BMI, kg/m2 | 23.3 (15.8–34.2) | 21.9 (17.7–34.6) | 0.942 | 23 (16.4–39.8) | 21 (16.2–36.7) | 0.068 | 0.107 |
Induction | |||||||
No | 4 (3.8%) | 2 (8.6%) | 2 (4.2%) | 2 (4.8%) | |||
Simulect | 23 (22.1%) | 12 (34.3%) | 0.15 | 12 (25%) | 12 (28.6%) | 0.91 | 0.666 |
ATG | 77 (74%) | 20 (57.1%) | 2 | 34 (70.8%) | 28 (67.2%) | 3 | |
Creatinine atdischarge (mg/dL) | 1.19 (0.47–6.58) | 1.17 (0.68–1.62) | 0.297 | 0.86 (0.45–2.1) | 0.88 (0.46–2.2) | 0.607 | <0.001 |
GFR at discharge (mL/dk/1.73 mL2) | 78.8 ± 28.4 | 86.7 ± 23.5 | 0.099 | 88.3 ± 26.7 | 87.9 ± 25.5 | 0.951 | 0.059 |
Final creatinine | 1.29 (0.7–12.2) | 1.2 (0.8–6.1) | 0.232 | 0.9 (0.54–8.23) | 0.95 (0.56–8.7) | 0.786 | <0.001 |
Final GFR | 66 (5–118) | 78 (11–128) | 0.173 | 72.9 ± 29.9 | 75.9 ± 29.6 | 0.641 | 0.118 |
Hospitalization days | 9 (6–42) | 8 (6–27) | 0.197 | 9 (6–39) | 9 (6–30) | 0.616 | 0.609 |
Greft biopsy, yes/no (%) | 30/74 (28.8%) | 7/28 (20%) | 0.306 | 10/38 (20.8%) | 6/36 (14.3%) | 0.418 | 0.252 |
Biopsy result | |||||||
Normal | 7 (23.3%) | 2 (28.6%) | |||||
Rejection | 12 (40%) | 2 (28.6%) | 1 (11.1%) | 1 (16.7%) | |||
BKVAN | 3 (10%) | 0 (0%) | 0.777 | 6 (66.7%) | 3 (50%) | 0.937 | 0.935 |
GN | 4 (13.3%) | 2 (28.6%) | 1 (11.1%) | 1 (16.7%) | |||
CAN | 4 (13.3%) | 1 (14.3%) | 1 (11.1%) | 1 (16.7%) | |||
Biopsy result | |||||||
Normal | 1 (3.3%) | 0 (%0) | 1.000 | 0 (%0) | 0 (0%) | 1.000 | 0.862 |
Anormal | 29 (96.7%) | 7 (%100) | 9 (%100) | 6 (100%) | |||
Recipient blood group | |||||||
0 | 24 (23.1%) d | 15 (%42.9) e | 14 (%39.2) | 14 (33.3%) | |||
A | 39 (37.5%) d | 13 (%37.1) d | 0.042 | 18 (%37.5) | 16 (38.1%) | 0.495 | 0.257 |
B | 30 (28.8%) d | 3 (%8.6) e | 11 (%22.9) | 11 (26.2%) | |||
AB | 11 (%10.6) d | 4 (%11.4) d | 5 (%10.4) | 1 (2.4%) | |||
Time spent on dialysis, months | 2 (0–240) | 3 (0–197) | 0.622 | 2.5 (0–132) | 0 (0–120) | 0.243 | 0.649 |
Preemptive, Yes/No (%) | 34/70 (%32.7) | 14/21 (%40) | 0.432 | 20/28 (%41.7) | 21/21 (%50) | 0.428 | 0.257 |
Number of mismatches | 3.5 (0–6) | 3 (0–6) | 0.025 | 3.5 (0–6) | 3 (0–5) | 0.008 | 0.004 |
Primary Kidney Disease | |||||||
DN | 11 (%10.6) | 5 (%14.3) | 3 (%6.3) | 0 (%0) | |||
HT | 16 (%15.4) | 0 (%0) | 12 (%25) | 8 (%19) | |||
GN | 10 (%9.6) | 5 (%14.3) | 3 (%6.3) | 3 (%7.1) | |||
Obstructive pathologies | 8 (%7.7) | 3 (%8.6) | 5 (%10.4) | 4 (%9.5) | |||
PKD | 1 (%1) | 1 (%2.9) | 0.091 | 0 (%0) | 1 (%2.4) | 0.639 | 0.250 |
TIN | 1 (%1) | 3 (%8.6) | 1 (%2.1) | 0 (%0) | |||
Amyloidosis | 1 (%1) | 0 (%0) | 2 (%4.2) | 1 (%2.4) | |||
Hereditary | 0 (%0) | 1 (%2.9) | 1 (%2.1) | 1 (%2.4) | |||
Unknown etiologies | 56 (%53.8) | 17 (%48.6) | 21 (%43.8) | 24 (%57.1) | |||
Pre-transplantation recipient | |||||||
HT | 34/70 (%32.7) | 9/26 (%74.3) | 0.440 | 13/35 (%27.1) | 9/33 (%21.4) | 0.533 | 0.550 |
DM | 7/97 (%6.7) | 0/35 (%0) | 0.115 | 4/44 (%8.3) | 1/41 (%2.4) | 0.367 | 0.260 |
CAD | 9/95 (%8.7) | 3/32 (%8.6) | 1.000 | 2/46 (%4.2) | 1/41 (%2.4) | 1.000 | 0.453 |
Post-transplantation | |||||||
HT | 79/25 (%76) | 28/7 (%80) | 0.623 | 33/15 (%68.8) | 23/19 (%54.8) | 0.172 | 0.050 |
DM, | 29/75 (%27.9) d | 4/31 (%11.4) d,e | 0.048 | 13/35 (%27.1) d,e | 3/39 (%7.1) e | 0.014 | 0.014 |
CAD | 9/95 (%8.7) | 3/32 (%8.6) | 1.000 | 2/46 (%4.2) | 1/41 (%2.4) | 1.000 | 0.453 |
Graft loss | 10/94 (%9.6) | 2/33 (%5.7) | 0.477 | 2/46 (%4.2) | 1/41 (%2.4) | 1.000 | 0.351 |
Mortality rate | 11/93 (%10.6) | 1/34 (%2.9) | 0.295 | 3/45 (%6.3) | 0/42 (%0) | 0.245 | 0.090 |
Donor age | 42 ± 11.4 | 43.4 ± 11.7 | 0.550 | 44 (21–61) | 46.8 (25–74) | 0.128 | 0.180 |
Donor BMI, kg/m2 | 26.7 (19.6–39.5) | 26.4 (19.1–34) | 0.325 | 25.6 ± 3.6 | 27.6 ± 4.7 | 0.035 | 0.093 |
Donor operation type | 0.293 | 0.172 | 0.377 | ||||
Open nephrectomy | 40 (%38.5) | 17 (%48.6) | 24 (%50) | 15 (%35.7) | |||
Laparoscopic nephrectomy | 64 (%61.5) | 18 (%51.4) | 24 (%50) | 27 (%67.3) | |||
Kidney removed left/right (%left) | 74/30 (%71.2) | 24/11 (%68.6) | 0.772 | 32/16 (%66.7) | 25/17 (%59.5) | 0.483 | 0.596 |
Number of arteries | 1 (1–3) | 1 (1–3) | 0.864 | 1 (1–2) | 1 (1–3) | 0.783 | 0.590 |
Donor GFR, mL/min/1.73 m2 | 111.5 ± 11.8 | 111.7 ± 11.8 | 0.913 | 110.8 ± 11.9 | 109 ± 9.9 | 0.432 | 0.712 |
Donor GFR/Recipient BMI | 4.85 ± 0.92 | 4.83 ± 1 | 0.905 | 4.7 (2.5–7.4) | 5.5 (2.4–6.7) | 0.143 | 0.296 |
Donor blood group | |||||||
0 | 57 (%54.8) | 18 (%51.4) | 24 (%50) | 20 (%47.6) | |||
A | 27 (%26) | 11 (%31.4) | 0.495 | 12 (%25) | 12 (%28.6) | 0.797 | 0.461 |
B | 16 (%15.4) | 3 (%8.6) | 11 (%22.9) | 10 (%23.8) | |||
AB | 4 (%3.8) | 3 (%8.6) | 1 (%2.1) | 0 (%0) |
Donor Age | p | ||
---|---|---|---|
<43 (n = 111) | ≥43 (n = 118) | ||
Donor GFR | 118 (83–143) | 107 (73–131) | <0.001 a |
Donor BMI | 25.9 (16.6–36.8) | 27.1 (18.9–39.5) | 0.001 a |
Recipient GFR at discharge (mL/dk/1.73 mL2) | 88.3 ± 23.4 | 79.4 ± 26.6 | 0.009 b |
Donor final creatinin | 1.09 (0.56–9.8) | 1.24 (0.54–12.2) | 0.026 a |
Donor final GFR | 75 (5–135) | 65.5 (5–126) | 0.008 a |
Median follow up time, month | 78.6 (8.4–136) | 59 (1–136.5) | 0.029 a |
Graft loss, yes/no (yes %) | 6/105 (%) | 9/109 (%) | 0.497 c |
Mortality rate, yes/no (yes %) | 5/106 (4.5%) | 10/108 (8.5%) | 0.225 c |
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© 2025 by the authors. Published by MDPI on behalf of the Lithuanian University of Health Sciences. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
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Cakmak, U.; Merhametsiz, O.; Ay, N. The Impact of Living Kidney Donor Glomerular Filtration Rate on Graft Survival. Medicina 2025, 61, 580. https://doi.org/10.3390/medicina61040580
Cakmak U, Merhametsiz O, Ay N. The Impact of Living Kidney Donor Glomerular Filtration Rate on Graft Survival. Medicina. 2025; 61(4):580. https://doi.org/10.3390/medicina61040580
Chicago/Turabian StyleCakmak, Umit, Ozgur Merhametsiz, and Nurettin Ay. 2025. "The Impact of Living Kidney Donor Glomerular Filtration Rate on Graft Survival" Medicina 61, no. 4: 580. https://doi.org/10.3390/medicina61040580
APA StyleCakmak, U., Merhametsiz, O., & Ay, N. (2025). The Impact of Living Kidney Donor Glomerular Filtration Rate on Graft Survival. Medicina, 61(4), 580. https://doi.org/10.3390/medicina61040580