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Assessment of Vascular Function in Patients With Chronic Kidney Disease

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Effects of living kidney donation on arterial stiffness: a systematic review protocol

Rosendo A Rodriguez¹, Mayra Trentin Sonoda², Mohsen Agharazii³

¹Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada rrodriguez1847@gmail.com.

|May 19, 2021

Insights

Kidney donation may increase aortic stiffness, a risk factor for cardiovascular disease. This systematic review will assess arterial stiffness changes in kidney donors versus non-donors to inform donor follow-up care.

Area of Science:

Cardiovascular Science
Nephrology
Systematic Review Methodology

Background:

Kidney donors may experience accelerated aortic stiffness and reduced glomerular filtration.
Increased aortic stiffness is a significant predictor of cardiovascular disease and mortality.
Understanding arterial stiffness changes post-donation is crucial for donor health.

Purpose of the Study:

To systematically review studies evaluating arterial stiffness in kidney donors compared to healthy non-donors.
To confirm whether arterial stiffness increases following unilateral nephrectomy for kidney donation.
To provide evidence for optimizing the long-term care of kidney donors.

Main Methods:

Comprehensive literature search of multiple databases (MEDLINE, EMBASE, etc.) from 1960 to 2021.
Inclusion of prospective and retrospective non-randomized studies comparing arterial stiffness indices in donors and non-donors.
Assessment of primary outcomes (arterial stiffness metrics) and secondary outcomes (blood pressure, renal function, etc.) with rigorous risk of bias and evidence grading.

Main Results:

This section is to be filled upon study completion.
The review will synthesize data on arterial stiffness, blood pressure, and renal function.
Heterogeneity will be assessed using Forest plots and I² statistics to guide meta-analysis.

Conclusions:

This systematic review will clarify the impact of kidney donation on arterial stiffness.
Findings will inform clinical guidelines for the cardiovascular evaluation and follow-up of kidney donors.
Evidence generated will support the long-term health and safety of individuals who donate kidneys.

Read full analysis

Abstract

Introduction:

Kidney donors have been reported to have accelerated progression of aortic stiffness and decreased glomerular filtration compared with healthy non-donors. This is a concern because increased aortic stiffness is an independent predictor of overall cardiovascular disease and all-cause mortality in the general population. To confirm if arterial stiffness increases after donation, we will systematically review all studies that evaluated indices of arterial stiffness in healthy individuals who underwent unilateral nephrectomy for kidney donation compared with age-matched healthy non-nephrectomised controls.

Methods/Analysis:

We will comprehensively search for studies published between 1 January 1960 and 15 March 2021 in MEDLINE, EMBASE, Cochrane Central, OVID and EBM reviews. All prospective (cohort, case-control, case series and before-and-after studies) and retrospective non-randomised studies reporting indices of arterial stiffness in nephrectomised and non-nephrectomised healthy participants will be included. Primary outcome will be the difference in the functional metrics of arterial stiffness between donors and non-donors. Secondary outcomes will be the differences in systolic/diastolic blood pressures, serum creatinine, glomerular filtration, carotid artery intima-media thickness and vascular calcification. Study screening, selection and data extraction will be performed by two independent reviewers. Risk of bias will be independently assessed with the ROBINS-I tool and confidence in evidence by the Grading of Recommendations Assessment, Development and Evaluation recommendations. Qualitative and quantitative data syntheses as well as clinical and statistical heterogeneity (Forest plots, I² and Cochran's Q statistics) will be evaluated. If clinical and statistical heterogeneity are acceptable, inverse variance-weighted effects will be analysed by random effect models.

Ethics And Dissemination:

No ethical approval is necessary. Our results will be disseminated through peer-review publication and presentations to guide stakeholders on the evaluation and follow-up care of kidney donors.

Prospero Registration Number:

CRD42020185551.

Keywords:

clinical physiology renal transplantation transplant medicine transplant surgery

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