Dr CHIANG SHENG LEE1,2, Associate Professor JORDAN LI1,2, Dr RAJIV JUNEJA1,2, Dr GEORGE PASSARIS1,2, Dr SHAHID ULLAH2, Ms JANE VAN DER JEUGD1, Professor JONATHAN GLEADLE1,2
1Renal Unit, Flinders Medical Centre, Bedford Park, Australia, 2College of Medicine and Public Health, Flinders University, Bedford Park, Australia
Aim:
To evaluate compensatory renal hypertrophy (CRH) of the allograft kidney in renal transplant recipients and relationship to estimated glomerular filtration rate (eGFR).
Background:
CRH is observed in patients nephrectomised for renal malignancy and living kidney donors following nephrectomy. The extent of transplant kidney hypertrophy and influence on graft function is not well studied. Understanding the factors associated with CRH in the transplanted kidney could shed light on the mechanisms driving CRH.
Methods:
A single centre retrospective study was undertaken of renal transplant recipients cared for by the Flinders Medical Centre Renal Unit from January 2007 to June 2020. Donor and recipient details, renal allograft length from serial transplant ultrasounds at months 0, 1, 3, 6 and 12 were collected. The primary outcome was occurrence and magnitude of CRH; secondary outcome was association of CRH with eGFR.
Results:
191 renal transplant recipients were studied, 61.3% male (n=117) and 38.7% female (n=74). 111 of 169 patients (65.7%) demonstrated CRH defined as any increase in maximal longitudinal diameter on serial ultrasounds. 22 patients were excluded due to absence of serial ultrasounds. The mean increase in kidney size over the first 12 months was 0.54 cm. 85 of 148 (57.4%) patients with renal ultrasound within a month post-transplant demonstrated enlargement. 9 patients (5.3%) had no significant change in transplant size and 49 patients (29%) had a decreased size. Univariate analysis demonstrated that eGFR increased by 3.3 ml/min/1.73m2 (95% CI 1.4 – 5.1, p<0.001) with every 1cm increase in kidney length.
Conclusion:
CRH is common in renal transplant recipients and associated with enhanced eGFR. Further studies will determine factors that influence the occurrence of CRH and improved transplant function.
Biography:
Dr Chiang Sheng Lee is a second year renal advanced trainee with a keen interest in general nephrology and transplantation.