Long-term consequences of kidney donation

Area of Science:

• Nephrology
• Transplant Surgery
• Public Health

Background:

• Growing interest in the long-term renal outcomes for living kidney donors.
• Existing evidence suggests similar survival and no increased risk of end-stage renal disease (ESRD) in living donors.
• Previous studies had limitations due to small sample sizes and short follow-up periods.

Purpose of the Study:

• To evaluate the long-term vital status and lifetime risk of ESRD in a large cohort of kidney donors.
• To assess renal function (GFR, albuminuria), prevalence of hypertension, general health, and quality of life in a subset of donors.

Main Methods:

• Ascertained vital status and ESRD risk in 3698 kidney donors (1963-2007).
• Measured glomerular filtration rate (GFR) and urinary albumin excretion in 255 donors (2003-2007).
• Assessed hypertension, general health, and quality of life in the 255-donor subgroup.

Main Results:

• Kidney donor survival matched general population controls.
• ESRD incidence was lower in donors (180/million person-years) vs. general population (268/million person-years).
• At mean 12.2 years post-donation, 85.5% had GFR ≥60 ml/min/1.73 m², 32.1% had hypertension, 12.7% had albuminuria. Older age and higher BMI correlated with lower GFR and hypertension; longer time post-donation correlated with albuminuria.
• Quality of life scores exceeded population norms; comorbid conditions were similar to matched controls.

Conclusions:

• Carefully screened living kidney donors exhibit survival and ESRD risks comparable to the general population.
• The majority of studied donors maintained preserved GFR and normal albumin excretion.
• Donors generally reported an excellent quality of life post-donation.