Patterns of End‐Stage Renal Disease Caused by Diabetes, Hypertension, and Glomerulonephritis in Live Kidney Donors. Issue 12 (12th July 2016)

• Record Type: Journal Article
• Authors: Anjum, S.; Muzaale, A. D.; Massie, A. B.; Bae, S.; Luo, X.; Grams, M. E.; Lentine, K. L.; Garg, A. X.; Segev, D. L.
• Is Part Of: American journal of transplantation. Volume 16:Issue 12(2016:Dec.)
• Page Start: 3540
• Page End: 3547
• Publication Date: 2016-07-12
• Subjects: clinical research/practice -- kidney transplantation/nephrology -- donors and donation: living -- donors and donation: donor follow‐up; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.13917
• Languages: English
• ISSNs: 1600-6135

Abstract

Abstract : Inferences about late risk of end‐stage renal disease (ESRD) in live kidney donors have been extrapolated from studies averaging <10 years of follow‐up. Because early (<10 years) and late (≥10 years) postdonation ESRD may differ by causal mechanism, it is possible that extrapolations are misleading. To better understand postdonation ESRD, we studied patterns of common etiologies including diabetes, hypertension and glomerulonephritis (GN; as reported by providers) using donor registry data linked to ESRD registry data. Overall, 125 427 donors were observed for a median of 11.0 years (interquartile range 5.3–15.7 years; maximum 25 years). The cumulative incidence of ESRD increased from 10 events per 10 000 at 10 years after donation to 85 events per 10 000 at 25 years after donation (late vs. early ESRD, adjusted for age, race and sex: incidence rate ratio [IRR]1.3 1.72.3 [subscripts are 95% confidence intervals]). Early postdonation ESRD was predominantly reported as GN‐ESRD; however, late postdonation ESRD was more frequently reported as diabetic ESRD and hypertensive ESRD (IRR2.3 7.725.2 and1.4 2.64.6, respectively). These time‐dependent patterns were not seen with GN‐ESRD (IRR0.4 0.71.2 ). Because ESRD in live kidney donors has traditionally been reported in studies averaging <10 years of follow‐up, our findings suggest caution in extrapolating such results over much longer intervals. Abstract : The authors report that the rare incidence of end‐stage renal disease in kidney donors predominantly occurs secondary to glomerulonephritis in the first decade following nephrectomy, but in subsequent decades end‐stage renal disease exponentially increases secondary to diabetes or hypertension. Read the companion study onpage 3532 .