Male Kidney Donors Recover Kidney Function Faster than Female Counterparts

Male kidney donors may experience greater kidney function recovery than females after donation, according to findings presented at the American Society of Nephrology Kidney Week 2023.

Despite similar predonation estimated glomerular filtration rate (eGFR) between male and female participants, males showed a significantly greater eGFR recovery than females through 24-month follow-up (P = .003), highlighting a potential need for sex-specific evaluation, counseling, and monitoring among kidney donors.¹

“Living donor kidney transplantation is the optimal treatment for end-stage kidney disease and requires donor risk assessment. More data is needed to understand kidney function recovery after donation,” wrote investigators.¹

Kidney transplants are necessary for patients experiencing kidney failure. Compared to dialysis, kidney transplantation offers most patients a better quality of life and a longer life expectancy, especially those performed using a kidney from a living donor, which has several advantages compared to transplants performed from deceased donors. However, limited data is available about the effect of perioperative risk factors on eGFR recovery for living donors after kidney donation.²

The present study, led by Austin Hilvert of Vanderbilt University Medical Center, was not the only research presented on disparities in kidney transplantation at ASN Kidney Week 2023. Maya Clark-Cutaia, RN, MSN, PhD, assistant professor of nursing at New York University Rory Meyers College of Nursing, also presented data about kidney transplantation, with her research focused on inequities in access to transplants based on race and ethnicity.³

To address knowledge gaps regarding the impact of perioperative risk factors on eGFR recovery and provide a comprehensive understanding of kidney function recovery after donation, investigators assessed the impact of BMI, age, and sex on post-donation eGFR in kidney donors over a 2-year period. To do so, they retrospectively collected data from 178 kidney donors who underwent living donor nephrectomy at a single medical center between November 2017 and January 2022. Follow-up visits occurred at approximate 1-month, 6-month, 12-month, and 24-month intervals, during which eGFR was calculated using the 2021 CKD-EPI equation.¹

Investigators used Friedman’s test to identify fluctuations in eGFR during the follow-up periods. Relationships between postdonation eGFR and BMI, age, and sex were assessed using a generalized least squares model with AR1 error structure, with identified relationships plotted using model-estimated eGFR values.¹

In total, 57 male and 121 female kidney donors were included in the study. Among the cohort, the median age at donation was 43.83 years and the median BMI was 25.93. Investigators pointed out median predonation eGFR was similar between male and female participants (98.85 vs 94.59; P = .184).¹

Upon analysis, predonation eGFR (P = .89), BMI (P = .37), and age (P = .17) did not significantly affect eGFR trajectories. However, investigators noted donor sex had a significant effect on eGFR trajectories, pointing out despite having initially lower eGFR than female participants (59.13 vs 65.21; P < .001), males showed a significantly greater eGFR recovery than females through 24 months of follow-up (P = .003).¹

“Our study suggests that male kidney donors recover kidney function to a greater degree than females after donation. These findings may have implications for donor evaluation, pre-operative patient counseling, and sex-specific monitoring,” concluded investigators.¹ “Further studies are needed to investigate underlying mechanisms and potential interventions to enhance eGFR recovery in both male and female kidney donors.”

References:

1. Hilvert AM, Grice JV, Mcgonigle TW, et al. Males Show Greater eGFR Recovery than Females Following Kidney Donation. Paper Presented at: American Society of Nephrology Kidney Week 2023. November 1-5, 2023.
2. Cleveland Clinic. Kidney Transplant. Treatments & Procedures. March 14, 2022. Accessed November 4, 2023. https://my.clevelandclinic.org/health/treatments/22537-kidney-transplant
3. Brooks, A. Study Highlights Disparities in Access to Kidney Transplantation Based on Race, Ethnicity. HCPLive. November 4, 2023. Accessed November 4, 2023. https://www.hcplive.com/view/study-highlights-disparities-in-access-to-kidney-transplantation-based-on-race-ethnicity