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Renal Function Profile in White Kidney Donors: The First 4 Decades
Hassan N Ibrahim1, Robert N Foley2, Scott A Reule2
1Division of Renal Diseases and Hypertension, and ibrah007@umn.edu.
Journal of the American Society of Nephrology : JASN
|February 19, 2016
Summary
Kidney donation carries a low risk of proteinuria and reduced kidney function. Postdonation diabetes and hypertension significantly increase the risk of these adverse renal outcomes.
Area of Science:
- Nephrology
- Transplantation
- Public Health
Background:
- Previous studies focused on end-stage renal disease (ESRD) risk post-kidney donation.
- Limited data exists on preceding renal outcomes like proteinuria and reduced glomerular filtration rate (GFR).
Purpose of the Study:
- To estimate the risk of proteinuria, reduced GFR, and ESRD in kidney donors.
- To assess the impact of postdonation hypertension and diabetes on these renal outcomes.
- To develop a predictive risk calculator for long-term renal outcomes in kidney donors.
Main Methods:
- Retrospective cohort study of 3956 white kidney donors.
- Analysis of proteinuria, estimated GFR (eGFR), and ESRD incidence over a mean follow-up of 16.6 years.
- Statistical modeling to assess risk factors including postdonation hypertension and diabetes, and to develop a risk calculator.
Main Results:
- 6.1% of donors developed proteinuria; higher risk observed in men and those with higher BMI.
- 36% reached an eGFR <60 ml/min/1.73 m², and 2.8% reached an eGFR <30 ml/min/1.73 m² or ESRD.
- Older age, higher BMI, and higher systolic blood pressure at donation predicted reduced eGFR or ESRD.
- Postdonation diabetes and hypertension were associated with a fourfold higher risk of proteinuria and >2-fold higher risk of ESRD.
Conclusions:
- Severe GFR reduction and ESRD are uncommon after kidney donation.
- Postdonation diabetes and hypertension are significant risk factors for adverse renal outcomes.
- Pre-donation information can predict long-term renal outcomes in white living kidney donors.
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