Risks for donors associated with living kidney donation: meta-analysis

Area of Science:

• Nephrology
• Transplant Surgery
• Public Health

Background:

• Living kidney donation is a critical procedure for end-stage renal disease treatment.
• Donor demographics, including age, sex, BMI, and ethnicity, may influence donation risks.
• Understanding these demographic influences is crucial for donor safety and long-term outcomes.

Purpose of the Study:

• To analyze how donor age, sex, body mass index (BMI), and ethnicity affect living kidney donation risks.
• To evaluate the impact of these characteristics on donor kidney function, surgical complications, and hypertension.
• To provide evidence-based insights for optimizing donor selection and care.

Main Methods:

• A systematic review and meta-analysis of existing studies.
• Inclusion of 31 studies from a pool of 5129 identified studies.
• Analysis focused on preoperative patient characteristics and their association with donor outcomes.

Main Results:

• Donors over 60 years old showed a mean eGFR decline of 9.54 ml/min/1.73 m² compared to younger donors.
• Obese donors (BMI > 30 kg/m²) had a significantly lower eGFR one year post-donation (-2.70 ml/min/1.73 m²) and higher blood pressure.
• Female donors exhibited better short- and long-term survival rates, while African donors had a higher long-term risk of end-stage renal disease (ESRD) compared to Caucasians.

Conclusions:

• Obesity and male sex are associated with inferior outcomes in living kidney donors.
• Older donors (over 60) experience a greater decline in estimated glomerular filtration rate (eGFR).
• African donors demonstrate a higher incidence of ESRD compared to Caucasian donors, highlighting ethnic disparities.