The following is a summary of “Early compensatory increase in single kidney estimated GFR after unilateral nephrectomy is associated with a lower long-term risk of estimated GFR decline,” published in the February 2025 issue of Nephrology Dialysis Transplantation by Weijden et al. 

A higher short-term increase in single-kidney GFR links to better long-term function in donors. Its impact on non-donors remains unknown. 

Researchers conducted a retrospective study to assess the link between ΔskGFR and long-term eGFR decline after unilateral nephrectomy.

They analyzed 1,777 SCREAM cohort participants who underwent radical unilateral nephrectomy in Stockholm (2006–2021). They calculated ΔskGFR as early (1–6 months) post-nephrectomy eGFR minus 50% of pre-nephrectomy eGFR. They used multivariable Cox regression to assess the link between ΔskGFR and progressive eGFR decline (>30% from 6-month eGFR) or kidney failure. 

The results showed that the mean age was 68 ± 11 years, 40% were female, and 92% had kidney cancer. Median pre-nephrectomy eGFR was 76 (61–89) mL/min/1.73 m², and median ΔskGFR was 11 (7–20) mL/min/1.73m². ΔskGFR was inversely linked to age and positively linked to pre-nephrectomy eGFR. Over a median 5-year follow-up (range 0.6–15 years), 178 developed progressive eGFR decline. Those with ΔskGFR above the median had a lower risk (HR: 0.58, 95% CI: 0.42–0.80), independent of baseline eGFR and age. 

Investigators found that a higher early increase in single-kidney eGFR was linked to a lower long-term risk of progressive eGFR decline. Evaluating ΔskGFR helped identify patients at higher risk of kidney function decline after unilateral nephrectomy. 

Source: academic.oup.com/ndt/advance-article/doi/10.1093/ndt/gfaf026/8029902