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Renal outcome 25 years after donor nephrectomy.
D A Goldfarb1, S F Matin, W E Braun
1Urological Institute and Department of Hypertension/Nephrology Cleveland Clinic Foundation, Cleveland, Ohio, USA.
The Journal of Urology
|November 7, 2001
Summary
Kidney donation is safe long-term, with renal function well-preserved 25 years post-nephrectomy. While some protein excretion increases, it poses no clinical risk for most kidney donors.
Area of Science:
- Nephrology
- Transplantation Surgery
- Urology
Background:
- Long-term donor renal outcome is crucial due to hyperfiltration injury concerns.
- Limited data exists on kidney donor outcomes beyond 20 years post-donation.
Purpose of the Study:
- To assess the long-term impact of donor nephrectomy on renal function.
- To evaluate urinary protein excretion and hypertension development in kidney donors after 20 years.
Main Methods:
- Retrospective study of 70 live kidney donors from 1963-1975.
- Assessed 24-hour creatinine clearance, serum creatinine, and urinary protein/albumin.
- Compared postoperative values with pre-donation baseline and age-adjusted norms.
Main Results:
- Mean follow-up was 25 years; creatinine clearance decreased to 72% of pre-donation levels.
- Serum creatinine and systolic blood pressure increased but remained within normal ranges.
- Males showed higher urinary protein/albumin excretion; proteinuria generally had no clinical consequence.
Conclusions:
- Renal function is well-preserved in most kidney donors at long-term follow-up (mean 25 years).
- Males exhibit higher proteinuria, but no significant clinical differences in renal function or blood pressure were observed.
- Pre-existing mild proteinuria may indicate a risk for future significant proteinuria in donors.