Post nephrectomy renal function: Donor nephrectomy versus radical nephrectomy

Abstract

Background/Aim. Monitoring the renal function following donor or radical nephrectomy due to kidney tumors is considered to be essential. The aim of this study was to compare pre-operative and post-operative renal function in patients who underwent donor nephrectomy in relation to patients who underwent radical nephrectomy due to renal malignancy. Methods. A retrospective case-control study was performed, which included 199 patients divided into two groups: Group 1 (105 patients) were patients who underwent donor nephrectomy due to living related/unrelated kidney transplantation, while group 2 (94 patients) was a control group and included patients who underwent radical nephrectomy due to clear cell renal cell carcinoma in the T1bNoM0 clinical stage, where this surgical procedure was the final form of treatment. Results. Pre-operative eGFR EPI in the donor group was 94.95 ml/min/1.73m2, while in the radical nephrectomy patient group it was 71.00 ml/min/1.73m2. Patients who underwent radical nephrectomy tended to have GFR below 60 ml/min/1.73m2 after ten years of follow-up compared with patients who underwent donor nephrectomy. In the donor nephrectomy group, the average GFR was 80.40 ml/min/1.73m2 and in the radical nephrectomy group it was 56.00 ml/min/1.73m2. A higher incidence of diabetes and hypertension was also observed in the donor nephrectomy group of patients compared to the radical nephrectomy group (HTA: 44.3% vs. 21.3%; diabetes: 22.6% vs. 9.6%, respectively). Conclusion. Comparative monitoring of these two groups showed that in both groups the recovery of renal reserve was achieved one year after nephrectomy, due to the known adaptive mechanisms. Regardless of the fact that with live transplantation in a kidney donor, we reduce the initial renal reserve (nephrectomy, permanent loss of renal mass), due to the adaptive mechanisms, kidney donors recover the kidney function within the first year after surgery.