Kidney Hyperfiltration After Nephrectomy: A Mechanism to Restore Kidney Function in Living Donors

Maruhum Bonar Marbun, Endang Susalit

Research output: Contribution to journalArticlepeer-review


Living donor kidney transplantation (LDKT) is the treatment of choice for patients with end stage renal disease (ESRD). Up to now, the studies reporting the impact of nephrectomy in living kidney donors to their future kidney function were limited. Most living donors undergo recovery of kidney function after nephrectomy owing to remnant kidneys' capability to compensate nephron loss through adaptive hyperfiltration. However, hyperfiltration may fail and turn out to be maladaptive, causing deterioration of donors' kidney function and increasing risk of chronic kidney disease (CKD) in long term. Hyperfiltration is caused by increased in kidney blood flow and glomerular hypertrophy. Both conditions are regulated by various factors. The adaptive hyperfiltration in the early phase after nephrectomy may play important role in determining long term kidney function, but factors affecting the process are still unclear. Hyperfiltration may also be influenced by donors' characteristics such as age, body mass index (BMI), family related to the recipient, arterial stiffness and intraoperative intrabdominal pressure. Further study to understand the mechanism of hyperfiltration is needed so that kidney transplant centers could anticipate its failure and the detrimental effects of nephrectomy in the future.

Original languageEnglish
Pages (from-to)413-419
Number of pages7
JournalActa medica Indonesiana
Issue number4
Publication statusPublished - 1 Oct 2020


  • Hyperfiltration
  • Kidney Function
  • Kidney transplantation
  • Living donor
  • Nephrectomy


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