Introduction

It was reported that some variables were revealed remain renal function after live donor nephrectomy. This study was conducted to determine the influence of visceral and subcutaneous adipose tissue on renal function in living kidney donors.

Methods

Between July 2013 and February 2015, a total of 75 kidney donors who underwent living donor nephrectomy at our institution were analyzed. Visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were measured at the level of the umbilicus using CT scan. The border of the intra-abdominal cavity was outlined on the CT image, the cross-sectional surface areas of the visceral fat and subcutaneous fat were calculated by a single urologist using Xelis CT software (INFINITT, Seoul, Korea)(Fig 1.). Renal function was estimated with the Modification of Diet in Renal Disease formula till six months after kidney donation. The relationship between preoperative visceral and subcutaneous adipose tissue and recovery of renal function was analyzed.

Results

Thirty-three donors (44%) were male, and 13 (17.3%) grafts were secured from the right side. The mean BMI was 23.5±2.6 kg/m2 and the mean preoperative eGFR was 103.0±19.6 mL/min/1.73 m2. The mean VAT was 73.0±41.6cm3; SAT was 117.5±70.2cm3, and VAT/SAT ratio was 0.7±0.5. On multivariate linear regression, preoperative eGFR, ?eGFR, and VAT/SAT ratio were independently associated with eGFR at 6th month (Table 2). A ROC curve analysis showed that preoperative eGFR, ?eGFR and VAT/SAT ratio were highly predictive of developing of CKDIII at 6th month after donor nephrectomy (AUC = 0.933, p < 0.001).

Conclusions

Pre-donation eGFR, ?eGFR and V/S ratio are associated with the development of delayed renal recovery (GFR <60 ml/min/1.72m2) 6th month after donation. VAT/SAT ratio was associated with the postoperative renal function in living kidney donors. Kidney donors with higher VAT/SAT ratio require close observation, given their predisposition to CKD III after donation

Funding

none