Follow-up Care of Living Kidney Donors in Alberta, Canada

Previous guidelines recommend that living kidney donors receive lifelong annual follow-up care to assess renal health.

To determine whether these best practice recommendations are currently being followed.

Retrospective cohort study using linked health care databases.

Alberta, Canada (2002-2014).

Living kidney donors.

We determined the proportion of donors who had annual outpatient physician visits and laboratory measurements for serum creatinine and albuminuria.

There were 534 living kidney donors with a median follow-up of 7 years (maximum 13 years). The median age at the time of donation was 41 years and 62% were women. Overall, 25% of donors had all 3 markers of care (physician visit, serum creatinine, albuminuria measurement) in each year of follow-up. Adherence to physician visits was higher than serum creatinine or albuminuria measurements (67% vs 31% vs 28% of donors, respectively). Donors with guideline-concordant care were more likely to be older, reside closer to the transplant center, and receive their nephrectomy in more recent years.

Our results may not be generalizable to other countries that do not have a similar universal health care system.

These findings suggest significant evidence-practice gaps, in that the majority of donors saw a physician, but the minority had measurements of kidney function or albuminuria. Future interventions should target improving follow-up care for all donors.