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Predicting new-baseline glomerular filtration rate (NBGFR) after donor nephrectomy: validation of a split renal function (SRF)-based formula

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Abstract

Background

Accurate prediction of post-donor nephrectomy (DN) glomerular filtration rate is potentially useful for evaluating and counselling living kidney donors. Currently, there are limited tools to evaluate post-operative new-baseline glomerular filtration rate (NBGFR) in kidney donors. We aim to validate a conceptually simple formula based on split renal function (SRF) previously developed for radical nephrectomy patients.

Methods

Eighty-three consecutive patients who underwent DN from 2010 to 2016 were included. Pre-operative CT imaging and functional data including pre-DN baseline Global GFR (108.2 ± 13.2 mL/min/1.73m2) were included. Observed NBGFR was defined as the latest eGFR 3–12 months post-DN. SRF, defined as volume of the contralateral non-resected kidney normalised by total volume of kidneys, was determined from pre-operative cross-sectional imaging (49.2 ± 2.36%). The equation derived from Rathi et al. is as detailed: Predicted NBGFR = 1.24 × (Global GFR Pre-DN) x (SRF).

Results

The relationship between predicted NBGFR (66.0 ± 8.29 mL/min/1.73m2) and observed NBGFR (74.9 ± 16.4 mL/min/1.73m2) was assessed by evaluating correlation coefficients, bias, precision, accuracy, and concordance. The new SRF-based formula for NBGFR prediction correlated strongly with observed post-operative NBGFR (Pearson’s r = 0.729) demonstrating minimal bias (median difference = 7.190 mL/min/1.73m2) with good accuracy (96.4% within ± 30%, 62.7% within ± 15%) and precision (IQR of bias =  − 0.094 to 16.227).

Conclusion

The SRF-based formula was also able to accurately discriminate all but one patient to an NBGFR of > 45 mL/min/1.73m2. We utilised the newly developed SRF-based formula for predicting NBGFR in a living kidney donor population. Counselling of donor post-operative renal outcomes may then be optimised pre-operatively.

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Data Availability

All data generated or analyzed during the study that is relevant is included in the published paper. The datasets generated during and/or analysed during this study is available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore

    Hoi Pong Nicholas Wong

  2. Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore

    Wei Zheng So

  3. Department of Urology, Ng Teng Fong General Hospital, Singapore, Singapore

    Vineet Gauhar

  4. Department of Urology, National University Hospital, Singapore, Singapore

    Benjamin Yen Seow Goh & Ho Yee Tiong

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  1. Hoi Pong Nicholas Wong
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  4. Benjamin Yen Seow Goh
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Contributions

HPNW: project development, data analysis, and manuscript writing. WZS: project development, data collection, and manuscript writing. VG: project development. YSBG: project development and data collection. HYT: project development and data collection. All authors approved and submitted the final version of the manuscript.

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Correspondence to Hoi Pong Nicholas Wong.

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DSRB approval was attained for this study at our institution.

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Wong, H.P.N., So, W.Z., Gauhar, V. et al. Predicting new-baseline glomerular filtration rate (NBGFR) after donor nephrectomy: validation of a split renal function (SRF)-based formula. World J Urol 42, 50 (2024). https://doi.org/10.1007/s00345-023-04759-4

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