RESUMEN
Kidney donation should not lead to deterioration of the donor's health condition, both during the perisurgical period and in the long term. Safety of a living kidney donor becomes a prerequisite for his/her qualification. Detailed diagnostic procedures are performed to exclude any abnormalities of his/her health condition. Additionally, a long-term post-donation follow-up system for kidney donors has been set up in Poland besides the restrictive qualification system. Transplantation centers are obligated to provide a diagnostic procedures for living organ donors as a part of the monitoring of their health condition and to ensure them a medical follow-up for 10 years after the donation. A total of 141 cases of unilateral nephroureterectomy performed in 2003-2014 to obtain a kidney for transplantation were considered. Medical files of post-donation diagnostic or therapeutic methods and their outcomes were retrospectively analyzed. The aim of the study was to assess the efficacy of monitoring of donors' health condition within the framework of the long-term follow-up system for kidney donors in the aspect of detection of the donation-independent abnormalities.
Asunto(s)
Cuidados Posteriores/métodos , Trasplante de Riñón , Donadores Vivos , Cuidados a Largo Plazo , Nefrectomía/efectos adversos , Recolección de Tejidos y Órganos/efectos adversos , Adulto , Anciano , Femenino , Humanos , Cuidados a Largo Plazo/métodos , Masculino , Persona de Mediana Edad , Nefrectomía/métodos , Polonia , Estudios Retrospectivos , Recolección de Tejidos y Órganos/métodosRESUMEN
BACKGROUND: The determination of kidney function plays a pivotal role in living donors renal assessment because of the long-term hazards of life with one kidney. Guidelines recommend estimation of glomerular filtration rate (GFR) by the Modification of Renal Disease (MDRD) or Cockroft-Gault equations for people with normal or near-normal renal function. Cystatin C (CysC) has been introduced as an alternative endogenous marker of GFR. OBJECTIVE: The objective of the study was to evaluate residual renal function among living kidney donors by comparing serum CysC concentrations and estimated GFR according to the MDRD formula or the Cockroft-Gault equation. PATIENTS AND METHODS: Forty living kidney donors showed a mean age of 46.14 years. Their GFR was estimated according to the abbreviated MDRD (aMDRD) and Cockroft-Gault formula adjusted for body surface area. Twenty-two donors underwent diethylenetriaminepentaacetic acid (DTPA) renal studies. Serum CysC concentrations were measured during the last follow-up visit. GFR values according to Cockroft-Gault formula and MDRD formula were correlated with CysC concentrations using Pearson's linear correlation. RESULTS: Mean GFR according to the aMDRD formula and Cocroft-Gault formula decreased after nephrectomy. The Cockroft-Gault formula overestimated the DTPA GFR in our study. No significant differences were observed between DTPA GFR and GFR estimated using the aMDRD equation. The rate of GFR decrease was approximately 0.8 mL/min/1.73 m(2) per year. No significant correlation was observed between serum CysC concentration and GFR. Microalbuminuria was observed in one patient after nephrectomy. CONCLUSIONS: aMDRD equation to estimate GFR is more precise than Cockroft-Gault formula and cystatin C in living kidney donors after nephrectomy and should be preferred model in these patients.
Asunto(s)
Cistatina C/sangre , Tasa de Filtración Glomerular , Trasplante de Riñón/métodos , Riñón/fisiopatología , Donadores Vivos , Nefrectomía , Recolección de Tejidos y Órganos/métodos , Adulto , Anciano , Biomarcadores/sangre , Femenino , Humanos , Riñón/diagnóstico por imagen , Riñón/metabolismo , Trasplante de Riñón/efectos adversos , Modelos Lineales , Masculino , Persona de Mediana Edad , Modelos Biológicos , Nefrectomía/efectos adversos , Valor Predictivo de las Pruebas , Cintigrafía , Radiofármacos , Pentetato de Tecnecio Tc 99m , Recolección de Tejidos y Órganos/efectos adversos , Resultado del TratamientoRESUMEN
Sodium ion is required for transport of L-alanine and alpha-aminoisobutyric acid (AIB) into cells and membrane vesicles of a marine pseudomonad. Initial rate data obtained at various Naplus and amino acid concentrations were tested for fit by least squares analysis to sequential and Ping-Pong equations. The sequential case is preferred statistically at the 99% confidence limit. Cotransport of AIB and Naplus in cells could not be detected, perhaps explained by efflux of Naplus shown to occur from these cells. The kinetic analysis is consistent with formation of a ternary complex involving Naplus and the amino acid.