Causes and timing of end‐stage renal disease after living kidney donation. Issue 5 (1st March 2018)

• Record Type: Journal Article
• Authors: Matas, Arthur J.; Berglund, Danielle M.; Vock, David M.; Ibrahim, Hassan N.
• Is Part Of: American journal of transplantation. Volume 18:Issue 5(2018)
• Page Start: 1140
• Page End: 1150
• Publication Date: 2018-03-01
• Subjects: clinical research/practice -- donor nephrectomy -- donors and donation -- donor follow‐up -- glomerular filtration rate (GFR) -- health services and outcomes research -- hypertension/antihypertensives -- kidney (native) function/dysfunction -- kidney transplantation/nephrology; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.14671
• Languages: English
• ISSNs: 1600-6135

Abstract

Abstract : End‐stage renal disease (ESRD) is a risk after kidney donation. We sought, in a large cohort of kidney donors, to determine the causes of donor ESRD, the interval from donation to ESRD, the role of the donor/recipient relationship, and the trajectory of the estimated GFR (eGFR) from donation to ESRD. From 1/1/1963 thru 12/31/2015, 4030 individuals underwent living donor nephrectomy at our center, as well as ascertainment of ESRD status. Of these, 39 developed ESRD (mean age ± standard deviation [SD] at ESRD, 62.4 ± 14.1 years; mean interval between donation and ESRD, 27.1 ± 9.8 years). Donors developing ESRD were more likely to be male, as well as smokers, and younger at donation, and to have donated to a first‐degree relative. Of donors with a known cause of ESRD (n = 25), 48% was due to diabetes and/or hypertension; only 2 from a disease that would have affected 1 kidney (cancer). Of those 25 with an ascertainable ESRD cause, 4 shared a similar etiology of ESRD with their recipient. Almost universally, thechange of eGFR over time was stable, until new‐onset disease (kidney or systemic). Knowledge of factors contributing to ESRD after living kidney donation can improve donor selection and counseling, as well as long‐term postdonation care. Abstract : In a single‐center study with long‐term living kidney donor follow‐up, the authors find that end‐stage renal disease is rare, occurs late postdonation (median, 30 years), and is commonly due to new‐onset disease. See Wainright et al's companion article (page 1129 ) and Gill's editorial (page 1041 ).