Risk Factors for Developing Low Estimated Glomerular Filtration Rate and Albuminuria in Living Kidney Donors
Bibliographic record
Abstract
Rationale & Objective Chronic kidney disease is associated with significant morbidity and mortality in the general population, but little is known about the incidence and risk factors associated with developing low eGFR and moderate-severe albuminuria in living kidney donors following nephrectomy. Study Design Retrospective, population-based cohort study. Setting & Participants: Kidney donors in Alberta, Canada. Exposure Donor nephrectomy between May 2001 and December 2017. Outcome 2 estimated glomerular filtration rate (eGFR) measurements <45 mL/min/1.73 m 2 or 2 measurements of moderate or severe albuminuria from one-year post-donation onwards that were at least 90 days apart. Analytical Approach Associations between potential risk factors and the primary outcome were assessed using Cox proportional hazard regression analyses. Results Over a median follow-up period of 8.6 years (interquartile range [IQR]: 4.7-12.6 years), 47 of 590 donors (8.0%) developed sustained low eGFR or moderate-severe albuminuria, with an incidence rate of 9.2 per 1000 person-years (95% confidence interval: 6.6-11.8). The median time for development of this outcome beyond the first year after nephrectomy was 2.9 years (IQR: 1.4-8.0 years). Within the first four years of follow-up, a 5 mL/min/1.73 m 2 lower pre-donation eGFR increased the hazard of developing post-donation low eGFR or moderate-severe albuminuria by 26% (aHR, 1.26; 95% CI, 1.10-1.44). Furthermore, donors were at higher risk of developing low eGFR or albuminuria if they had evidence of pre-donation hypertension (aHR, 2.52; 95% CI, 1.28-4.96) or post-donation diabetes (aHR, 4.72; 95% CI, 1.54-14.50). Limitations We lacked data on certain donor characteristics that may impact long-term kidney function such as race, smoking history, and transplant-related characteristics. Conclusions A proportion of kidney donors, at an incidence rate of 9.2 per 1,000 person-years, will develop low eGFR or albuminuria after donation. Donors with lower pre-donation eGFR, pre-donation hypertension, and post-donation diabetes are at increased risk of developing this outcome.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".