Demographic Variability of Kidney Function in Live Donors: A Single-Centre Analysis

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Background: Live donation is encouraged as better outcomes in kidney transplant recipients. Donor assessment requires thorough evaluation but kidney function varies with demographics. We compre mGFR with the performance of eGFR formulas and creatinine clearances Methods: Analysis of 997 live donors between February1995 and October2019. Using pre-donation measured GFR(Tc EDTA-GFR) as the gold standard, we compared the performance of CKD-MDRD,CKD -EPI(ml/min/1.73m2),24hour creatinine clearance(Cr Cl) and Creatinine clearance by Cockcroft Gault(CrCl C-G)(ml/min) between age, ethnicity, and gender. We also calculated the relative bias(mGFR-eGFR/mGFR), root mean square error and the accuracy(P30)(eGFR between+-30%mGFR)of different eGFR equations Results: 422(42.32%)male donors. 616(62%) Caucasian, 228(23%) South Asian, 114(11%) Afro Caribbean and39(4%) of other ethnic groups(Arabic, oriental and mixed ethnicity)(Graph1).Mean mGFR was 100.08(SD 10.87). Mean mGFR for males and females were 105.77 vs 96.27, respectively(p=0.05).63(6%) donors were >65 years. Mean mGFR comparing young and >65 years old donors were 103.44 vs 82.27, respectively(p= 0.0028). As predicted, there is a linear decline in mGFR with increasing age. Cr Cl C-G has a tendency towards underestimating function in healthy living donors over 65 years old .GFR calculated by CKD-EPI formula was comparable to mGFR amongst all age groups, genders and ethnically diverse living donors .CKD-EPI performed better in terms of least bias and highest accuracy compared to MDRD for all donor subgroups(Table1). Conclusions: mGFR declines with age and healthy older donors have significantly lower mGFR compared to younger donors. Cr Cl overestimates kidney function and should be used with caution.eGFR by CKD EPI comes closest compared to mGFR in all groups. It could be reliably used as first screening tool for assessing function of living donors pre donation, irrespective of age, gender or ethnicity.Demographics & Comparitive performances

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