P P Reese1, M K Simon, J Stewart, R D Bloom. 1. Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA. peter.reese@uphs.upenn.edu
Abstract
BACKGROUND: Concerns have been raised that many kidney donors do not receive adequate medical care after nephrectomy. In 2003, our program developed a policy recommending that donors receive medical follow-up by 12 months postnephrectomy. We hypothesized that medically complex donors would have a higher rate of follow-up than other donors. METHODS: A retrospective cohort study of 137 live kidney donors from a single center was performed. Donors were considered medically complex if they had hypertension, body mass index of 30 or greater, nephrolithiasis, age 65 years or older, creatinine clearance less than 80 mL/min/1.73 m(2), or had a first-degree relative with diabetes mellitus. Adequate follow-up was defined as one visit with a nephrologist at our center, or blood pressure, serum creatinine, and urinalysis checked elsewhere. RESULTS: Eighty-three donors (61%) had adequate follow-up, 42 did not, and 12 could not be contacted. At multivariate logistic regression, donors with adequate follow-up were more likely to be medically complex (odds ratio, 2.48; 95% confidence interval 1.18-5.23; P = .02) and older than donors with inadequate follow-up (odds ratio, 1.46 per 10 years of age; 95% confidence interval, 1.01-2.10; P = .04). CONCLUSION: A substantial minority of donors do not receive recommended care by 1 year after nephrectomy.
BACKGROUND: Concerns have been raised that many kidney donors do not receive adequate medical care after nephrectomy. In 2003, our program developed a policy recommending that donors receive medical follow-up by 12 months postnephrectomy. We hypothesized that medically complex donors would have a higher rate of follow-up than other donors. METHODS: A retrospective cohort study of 137 live kidney donors from a single center was performed. Donors were considered medically complex if they had hypertension, body mass index of 30 or greater, nephrolithiasis, age 65 years or older, creatinine clearance less than 80 mL/min/1.73 m(2), or had a first-degree relative with diabetes mellitus. Adequate follow-up was defined as one visit with a nephrologist at our center, or blood pressure, serum creatinine, and urinalysis checked elsewhere. RESULTS: Eighty-three donors (61%) had adequate follow-up, 42 did not, and 12 could not be contacted. At multivariate logistic regression, donors with adequate follow-up were more likely to be medically complex (odds ratio, 2.48; 95% confidence interval 1.18-5.23; P = .02) and older than donors with inadequate follow-up (odds ratio, 1.46 per 10 years of age; 95% confidence interval, 1.01-2.10; P = .04). CONCLUSION: A substantial minority of donors do not receive recommended care by 1 year after nephrectomy.
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