Long-term follow-up of living kidney donors: a longitudinal study

To analyse retrospectively the general health status and renal and cardiovascular consequences of living-related kidney donation, as the long-term effects of unilateral nephrectomy for kidney donation are of particular interest with the currently increasing practice of living-donor transplantation.

Living-related kidney donors (1400) who had donated their kidneys between 1976 and 2002 were asked to attend a dedicated donor follow-up clinic starting in 2004. We attempted to contact all donors to determine the long-term outcome of their remaining kidney. All kidney donors who responded had a detailed assessment, and were questioned about rehabilitation and their feelings on donating a kidney. The data were compared to the age-matched health tables of the Egyptian general population.

In all, 339 donors had a complete evaluation (mean age at the time of evaluation 47.8 years, sd 11; mean follow-up 10.7 years, sd 4.9). The mean (sd) creatinine level after donation was 1.1 (1.2) mg/dL, and creatinine clearance 109 (33) mL/min; the clearance was <60 mL/min in 0.9% of donors and proteinuria was >300 mg/24 h in 1.5% of donors. Seventy-five (22.1%) donors became hypertensive and the rate was higher in donors with an interval of >25 years from donation; 174 (51.3%) of patients became either overweight or obese. Diabetes mellitus developed in 23 (6.8%) and was more common in patients with significant weight gain.

Donor nephrectomy has minimal adverse effects on overall health status. Regular donor follow-up identifies at-risk populations and potentially modifiable factors.