Abstract：
OBJECTIVE: This study investigated the follow-up rate of living kidney donors and explored the factors related to continuous follow-up and remnant renal function, enabling the optimal management of living kidney donors.
METHODS: We retrospectively evaluated 180 living kidney donors who underwent donor nephrectomies at our institute. Clinical information was obtained from medical charts, and remnant renal function was defined as the estimated glomerular filtration rate 12 months after donor nephrectomy.
RESULTS: Overall, 6/180 donors (3.3%) were lost to follow-up within a year, and the follow-up rate gradually declined yearly. Independent risk factors for loss to follow-up included a follow-up period <60 months and graft survival of the recipient (p=0.002 and p=0.043, respectively). Recipient survival was correlated with loss to follow-up; however, this was not significant (p=0.051). Regarding remnant renal function, age ≥60 years, preoperative estimated glomerular filtration rate <74 ml/min/1.73 m2, and a Δsingle-kidney estimated glomerular filtration rate <9.3 ml/min/1.73m2 were independent risk factors for poorly preserved remnant renal function (p=0.036, p<0.0001, and p<0.0001, respectively). Using propensity score matching to adjust for preoperative factors, a Δsingle-kidney estimated glomerular filtration rate <9.3 ml/min/1.73 m2 was the only significant postoperative factor for poorly preserved remnant renal function (p=0.023).
CONCLUSIONS: An increased 5-year follow-up rate could lead to an increase in long-term follow-up, and recipient prognosis may be correlated with the living kidney donor follow-up status. Furthermore, Δsingle-kidney estimated glomerular filtration rate was identified as a factor for establishing the optimal precision follow-up management of living kidney donors.
METHODS: We retrospectively evaluated 180 living kidney donors who underwent donor nephrectomies at our institute. Clinical information was obtained from medical charts, and remnant renal function was defined as the estimated glomerular filtration rate 12 months after donor nephrectomy.
RESULTS: Overall, 6/180 donors (3.3%) were lost to follow-up within a year, and the follow-up rate gradually declined yearly. Independent risk factors for loss to follow-up included a follow-up period <60 months and graft survival of the recipient (p=0.002 and p=0.043, respectively). Recipient survival was correlated with loss to follow-up; however, this was not significant (p=0.051). Regarding remnant renal function, age ≥60 years, preoperative estimated glomerular filtration rate <74 ml/min/1.73 m2, and a Δsingle-kidney estimated glomerular filtration rate <9.3 ml/min/1.73m2 were independent risk factors for poorly preserved remnant renal function (p=0.036, p<0.0001, and p<0.0001, respectively). Using propensity score matching to adjust for preoperative factors, a Δsingle-kidney estimated glomerular filtration rate <9.3 ml/min/1.73 m2 was the only significant postoperative factor for poorly preserved remnant renal function (p=0.023).
CONCLUSIONS: An increased 5-year follow-up rate could lead to an increase in long-term follow-up, and recipient prognosis may be correlated with the living kidney donor follow-up status. Furthermore, Δsingle-kidney estimated glomerular filtration rate was identified as a factor for establishing the optimal precision follow-up management of living kidney donors.
摘要：
目的：本研究调查了活体肾脏供体的随访率，并探讨了与持续随访和残余肾功能相关的因素。实现活体肾脏捐献者的最佳管理。
方法：我们回顾性评估了在我们研究所接受供体肾切除术的180例活体肾供体。临床信息来自医学图表，残余肾功能定义为供体肾切除术后12个月的估计肾小球滤过率。
结果：总体而言，6/180捐助者（3.3％）在一年内失去随访，随访率逐年下降。随访失败的独立危险因素包括随访期<60个月和接受者的移植物存活（分别为p=0.002和p=0.043）。受者生存与随访失败相关；然而，这并不显著(p=0.051).关于残余肾功能，年龄≥60岁，术前估计肾小球滤过率<74ml/min/1.73m2和Δ单肾估计肾小球滤过率<9.3ml/min/1.73m2是残余肾功能保存不良的独立危险因素(分别为p=0.036,p<0.0001和p<0.0001).使用倾向评分匹配来调整术前因素，aΔ单肾估计肾小球滤过率<9.3ml/min/1.73m2是残余肾功能保存不良的唯一重要术后因素（p=0.023）。
结论：增加5年随访率可能会导致长期随访增加，受者预后可能与活体供肾随访状态相关。此外，Δ单肾估计的肾小球滤过率被确定为建立活体肾脏供体的最佳精确随访管理的因素。
方法：我们回顾性评估了在我们研究所接受供体肾切除术的180例活体肾供体。临床信息来自医学图表，残余肾功能定义为供体肾切除术后12个月的估计肾小球滤过率。
结果：总体而言，6/180捐助者（3.3％）在一年内失去随访，随访率逐年下降。随访失败的独立危险因素包括随访期<60个月和接受者的移植物存活（分别为p=0.002和p=0.043）。受者生存与随访失败相关；然而，这并不显著(p=0.051).关于残余肾功能，年龄≥60岁，术前估计肾小球滤过率<74ml/min/1.73m2和Δ单肾估计肾小球滤过率<9.3ml/min/1.73m2是残余肾功能保存不良的独立危险因素(分别为p=0.036,p<0.0001和p<0.0001).使用倾向评分匹配来调整术前因素，aΔ单肾估计肾小球滤过率<9.3ml/min/1.73m2是残余肾功能保存不良的唯一重要术后因素（p=0.023）。
结论：增加5年随访率可能会导致长期随访增加，受者预后可能与活体供肾随访状态相关。此外，Δ单肾估计的肾小球滤过率被确定为建立活体肾脏供体的最佳精确随访管理的因素。
