A prospective observational study of changes in renal function and cardiovascular risk following living kidney donation.

The effect of unilateral nephrectomy on the cardiovascular risk profile of living kidney donors has not been prospectively studied. We performed an observational cohort study of 58 living donors to 6 months postdonation for changes in 24-hr ambulatory blood pressure profiles, renal function, urine protein excretion, body mass index, glucose tolerance, and fasting lipid profiles. The 24-hr systolic blood pressure average and night-day ratio were unchanged from pre- to postdonation (118.9+/-11 vs. 118.1+/-14 mm Hg, P=0.77; 0.87+/-0.07 vs. 0.87+/-0.09, P=0.68, respectively). Estimated glomerular filtration rate declined from 91.9+/-16 to 61.6+/-12 mL/min/1.73 m2 (P<0.0001). Protein excretion, body mass index, glucose, and lipids were unchanged. No significant differences were noted between dippers and nondippers either pre- or postdonation. In summary, living kidney donation in the short term is safe. We suggest further observation of individuals with lower glomerular filtration rate for possible increased cardiovascular risk factors in the future.