Renal function in living related kidney donors above the age of 70

Introduction

Living related kidney donors are highly motivated for donation. Older donors may have increased risks in the perioperative and postoperative period. Age limits for donors was insisted on in the past. The glomerular filtration rate in older people is only slightly lower than in young individuals in the absence of primary renal disease or confounding cardiovascular disease. The aim of the study was to assess renal function of living related donors above the age of 70 in the early postoperative period.

Methods

From March 2007 to November 2009, in Clinical Centre Nis, 25 living related donors donated their kidneys. The serum creatinine and calculated creatinine clearance (MDRD formula) were evaluated preoperatively, first, third and fifth postoperative days in the group under (U) and in the group above (A) the age of 70.

Results

There were 16 donors in group U (mean age 59, SD 5.38) and nine donors in group A (mean age 72.4, SD 1.88). The mean serum creatinine level in group U was 64.66 μmol/l (SD 12.22), 120.2 μmol/l (SD 26.04), 120.91 μmol/l (SD 21.68) and 116.07 μmol/l (SD 21.35) preoperatively, on the first, third and fifth postoperative days, respectively. In group A the mean serum creatinine level was 84.58 μmol/l (SD 23.63), 150.64 μmol/l (SD 38.67), 149.49 (SD 43.68) and 148.36 μmol/l (SD 39.08) preoperatively, first, third and fifth postoperative days, respectively. Calculated creatinine clearance in group U was 102.62 ml/minute/1.73 m² (SD 20.61), 50.44 ml/minute/1.73 m² (SD 10.28), 48.69 ml/minute/1.73 m² (SD 7.88) and 51.62 ml/minute/1.73 m² (SD 8.96) preoperatively, first, third and fifth postoperative days, respectively, and in group A 78.11 ml/minute/1.73 m² (SD 23.31), 39.11 ml/minute/1.73 m² (SD 10.35), 40.56 ml/minute/1.73 m² (SD 12.31) and 40.44 ml/minute/1.73 m² (SD 11.36) preoperatively, first, third and fifth postoperative days, respectively. There is a statistically significant difference in serum creatinine level between groups A and U preoperatively (P = 0.039) and on the fifth postoperative day (P = 0.043), and there is a statistically significant difference in glomerular filtration rate between groups A and U preoperatively (P = 0.019), on the first (P = 0.018) and fifth postoperative days (P = 0.024).

Conclusions

Deterioration of residual kidney function in the early postoperative period is higher in living donors above the age of 70. Patients over the age of 70 must be accepted with care for kidney donation.