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Adherence to Medical Appointments Among Living Kidney Donors After Donation Under a Monitored Approach and Long-term

P R Bicalho1, L R Requião-Moura2, M Borrelli Júnior1

  • 1Renal Transplantation Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil.

Transplantation Proceedings
|June 4, 2019
PubMed

Insights

Long-term follow-up for Brazilian living kidney donors shows improved appointment adherence with a structured approach. While hypertension and diabetes incidence is lower than the general population, chronic kidney disease rates are notably high.

Area of Science:

  • Nephrology
  • Transplant Surgery
  • Public Health

Background:

  • Limited data exists on long-term outcomes for living kidney donors in Brazil.
  • Evaluating donor adherence to medical follow-up is crucial for post-donation health.

Purpose of the Study:

  • To assess long-term outcomes in Brazilian living kidney donors.
  • To measure donor adherence to regular medical appointments.
  • To analyze the incidence of hypertension, diabetes mellitus, and chronic kidney disease post-donation.

Main Methods:

  • A single-center cohort study of 397 Brazilian living kidney donors with a median follow-up of 87.1 months.
  • Comparison of appointment adherence before and after implementing a structured donor follow-up protocol.
  • Evaluation of long-term outcomes including survival, chronic kidney disease (CKD), hypertension, diabetes mellitus (DM), and dyslipidemia.

Main Results:

  • Adherence to annual appointments increased significantly with the structured approach, reaching 75.8% (54.7% annual regularity).
  • 10-year cumulative incidences: hypertension 20.4%, DM 5.7%, dyslipidemia 23.5%. Crude mortality was 1%, with 10-year donor survival at 98.5%.
  • Five-year incidence of CKD was 19% (16.4% stage 3a, 2.6% stage 3b).

Conclusions:

  • A structured follow-up system effectively doubled adherence to donor appointments.
  • Living kidney donors exhibited lower rates of hypertension and DM compared to the Brazilian general population.
  • The 5-year incidence of chronic kidney disease among living donors is a significant concern requiring further investigation.
Abstract

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