#5661 EARLY COMPENSATORY INCREASE IN SINGLE-KIDNEY EGFR AFTER UNILATERAL NEPHRECTOMY IS ASSOCIATED WITH A LOWER LONG-TERM RISK OF EGFR DECLINE

Abstract Background and Aims The healthy kidney has reserve capacity, allowing for an increase in single-kidney GFR (ΔskGFR) the remaining after nephrectomy. We evaluated whether higher ΔskGFR, as a reflection of renal resilience, is associated with lower long-term risk eGFR decline individuals undergoing unilateral Method included 1777 participants from observational SCREAM project who underwent radical nephrectomy Stockholm during 2006–2021. calculated ΔskGFR using (CKD-EPI 2009) at 3 months post-nephrectomy minus 50% pre-nephrectomy its determinants (age, sex, eGFR, comorbidities) multivariable linear regression. Follow-up started 3-months post-nephrectomy, Cox regression was used to explore association between Δsk-GFR subsequent CKD progression (defined composite >30% relative three or initiation replacement therapy), adjusting age, sex eGFR. Results Mean (SD) age 68 ± 11 years, 40% patients were female, 92% had cancer diagnosis mean 75 19 mL/min/1.73m2. Median (IQR) (7–20) Pre-nephrectomy (St.Β = −0.20, P≪0.001) 0.14, P<0.001). During median follow-up 4 years (maximum 15 years), 178 developed progression. group above value (11 mL/min/1.73m2) 42% (adjusted HR: 0.58, 95% CI: 0.42 – 0.80), compared those (Figure). Conclusion A larger compensatory early nephrectomy, suggesting better follow-up. Evaluation could help identify progressive function decline.