Shiromani Janki1, Abbas Dehghan2,3, Jacqueline van de Wetering4, Ewout W Steyerberg5,6, Karel W J Klop1, Hendrikus J A N Kimenai1, Dimitris Rizopoulos7, Ewout J Hoorn4, Sylvia Stracke8, Willem Weimar4, Henry Völzke8, Albert Hofman2,9, Jan N M Ijzermans10. 1. Department of Surgery, Division of HPB and Transplant Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands. 2. Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands. 3. Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK. 4. Department of Internal Medicine, Division of Nephrology and Transplantation, Erasmus University Medical Center, Rotterdam, The Netherlands. 5. Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands. 6. Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands. 7. Department of Biostatistics, Erasmus University Medical Center, Rotterdam, The Netherlands. 8. Institute for Community Medicine, Ernst Moritz Arndt University Greifswald, Greifswald, Germany. 9. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 10. Department of Surgery, Division of HPB and Transplant Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands. j.ijzermans@erasmusmc.nl.
Abstract
BACKGROUND: Live donor nephrectomy is a safe procedure. However, long-term donor prognosis is debated, necessitating high-quality studies. METHODS: A follow-up study of 761 living kidney donors was conducted, who visited the outpatient clinic and were propensity score matched and compared to 1522 non-donors from population-based cohort studies. Primary outcome was kidney function. Secondary outcomes were BMI (kg/m2), incidences of hypertension, diabetes, cardiovascular events, cardiovascular and overall mortality, and quality of life. RESULTS: Median follow-up after donation was 8.0 years. Donors had an increase in serum creatinine of 26 μmol/l (95% CI 24-28), a decrease in eGFR of 27 ml/min/1.73 m2 (95% CI - 29 to - 26), and an eGFR decline of 32% (95% CI 30-33) as compared to non-donors. There was no difference in outcomes between the groups for ESRD, microalbuminuria, BMI, incidence of diabetes or cardiovascular events, and mortality. A lower risk of new-onset hypertension (OR 0.45, 95% CI 0.33-0.62) was found among donors. The EQ-5D health-related scores were higher among donors, whereas the SF-12 physical and mental component scores were lower. CONCLUSION: Loss of kidney mass after live donation does not translate into negative long-term outcomes in terms of morbidity and mortality compared to non-donors. TRIAL REGISTRATION: Dutch Trial Register NTR3795.
BACKGROUND: Live donor nephrectomy is a safe procedure. However, long-term donor prognosis is debated, necessitating high-quality studies. METHODS: A follow-up study of 761 living kidney donors was conducted, who visited the outpatient clinic and were propensity score matched and compared to 1522 non-donors from population-based cohort studies. Primary outcome was kidney function. Secondary outcomes were BMI (kg/m2), incidences of hypertension, diabetes, cardiovascular events, cardiovascular and overall mortality, and quality of life. RESULTS: Median follow-up after donation was 8.0 years. Donors had an increase in serum creatinine of 26 μmol/l (95% CI 24-28), a decrease in eGFR of 27 ml/min/1.73 m2 (95% CI - 29 to - 26), and an eGFR decline of 32% (95% CI 30-33) as compared to non-donors. There was no difference in outcomes between the groups for ESRD, microalbuminuria, BMI, incidence of diabetes or cardiovascular events, and mortality. A lower risk of new-onset hypertension (OR 0.45, 95% CI 0.33-0.62) was found among donors. The EQ-5D health-related scores were higher among donors, whereas the SF-12 physical and mental component scores were lower. CONCLUSION: Loss of kidney mass after live donation does not translate into negative long-term outcomes in terms of morbidity and mortality compared to non-donors. TRIAL REGISTRATION: Dutch Trial Register NTR3795.
Entities:
Keywords:
Live kidney donor; Long-term; Outcome; Renal function
Authors: Eunjeong Kang; Sehoon Park; Jina Park; Yaerim Kim; Minsu Park; Kwangsoo Kim; Hyo Jeong Kim; Miyeun Han; Jang-Hee Cho; Jung Pyo Lee; Sik Lee; Soo Wan Kim; Sang Min Park; Dong-Wan Chae; Ho Jun Chin; Yong Chul Kim; Yon Su Kim; Insun Choi; Hajeong Lee Journal: Kidney Res Clin Pract Date: 2021-11-05