{"doi":"10.1093/ndt/gfaf026","title":"Early compensatory increase in single-kidney estimated GFR after unilateral nephrectomy is associated with a lower long-term risk of estimated GFR decline","abstract":"BACKGROUND AND HYPOTHESIS: A more pronounced short-term increase in single-kidney GFR (ΔskGFR) has been associated with better long-term kidney function in living kidney donors. Whether this also applies to non-donors is unknown. We evaluated whether ΔskGFR is associated with long-term risk of eGFR decline in individuals undergoing unilateral nephrectomy. METHODS: This study included 1777 participants from the SCREAM cohort who underwent radical unilateral nephrectomy in Stockholm between 2006 and 2021. The ΔskGFR was calculated as the early (1-6 months) post-nephrectomy eGFR minus 50% of the pre-nephrectomy eGFR. Multivariable Cox regression was used to study the association between Δsk-GFR and the subsequent risk of progressive eGFR decline, defined as composite of an eGFR decline >30% compared to the early (6 months) post-nephrectomy eGFR or kidney failure. RESULTS: Mean age at nephrectomy was 68 ± 11 years, 40% were female, 92% had kidney cancer, and median (IQR) pre-nephrectomy eGFR was 76 (61-89) ml/min/1.73 m2. Median Δsk-GFR was 11 (7-20) ml/min/1.73 m2. Pre-nephrectomy determinants of Δsk-GFR were age (inverse association) and pre-nephrectomy eGFR (positive association). During a median follow-up of 5 years (range 0.6-15 years), 178 participants developed progressive eGFR decline. Individuals with a Δsk-GFR above the median had a lower rate of progressive eGFR decline (adjusted HR: 0.58, 95% CI: 0.42-0.80), compared to those with a Δsk-GFR below the median, independent of baseline eGFR and age. CONCLUSIONS: A stronger increase in single-kidney eGFR early after unilateral nephrectomy was associated with a lower long-term risk of progressive eGFR decline. Evaluation of Δsk-GFR could help identify patients at higher risk of progressive kidney function decline following unilateral nephrectomy.","journal":"Nephrology Dialysis Transplantation","year":2025,"id":538861,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9632,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1202968,"name":"Faizan Mazhar","orcid":"0000-0002-2818-1179","position":1,"is_corresponding":false},{"id":856089,"name":"Edouard L. Fu","orcid":"0000-0002-9698-6825","position":2,"is_corresponding":false},{"id":942136,"name":"Marco van Londen","orcid":"0000-0001-7145-3240","position":3,"is_corresponding":false},{"id":857940,"name":"Marie Evans","orcid":"0000-0001-8650-5795","position":4,"is_corresponding":false},{"id":247121,"name":"Stefan P. Berger","orcid":"0000-0003-2228-4676","position":5,"is_corresponding":false},{"id":727249,"name":"Martin H. de Borst","orcid":"0000-0002-4127-8733","position":6,"is_corresponding":false},{"id":19388,"name":"Juan Jesús Carrero","orcid":"0000-0003-4763-2024","position":7,"is_corresponding":false},{"id":942137,"name":"Jessica van der Weijden","orcid":"0000-0003-0247-7526","position":0,"is_corresponding":true}],"reference_count":40,"raw_metadata":null,"created_at":"2026-07-19T02:52:25.799399Z","pmid":"39984754","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}