Single-Center Experience With Complications and Clinical Outcomes of 464 Living Kidney Donors

This retrospective single-center cohort study reports the complications and outcomes experienced by living kidney donors.

Our study involved 464 donors who donated a kidney between January 2004 and March 2023 at the University Hospital Essen.

Of the 452 available donors having clinical assessment for arterial hypertension, 101 (22%) exhibited arterial hypertension at the time of donation, whereas 112 of the 351 (32%) donors without preexisting arterial hypertension experienced new-onset arterial hypertension at follow-up after donation. The development of arterial hypertension after donation was related to male sex, older age, elevated body mass index (BMI), and elevated cholesterol levels at donation but did not relevantly affect renal function after donation. Preexisting arterial hypertension was associated with a reduction in the estimated glomerular filtration rate (eGFR) and an increase in creatinine levels at donation and over the entire follow-up period. Follow-up at 1 year after donation found that eGFR levels were significantly lower than predonation levels (P < .0001). No significant changes in the incidence of proteinuria (P = .20) or albuminuria (P = .17) were found at 1-year follow-up. At 1 year after donation, 98 of 270 (36%) available donors had retained 70% or more of their baseline renal function related to eGFR determined at donation.

Our results suggest an increased risk of new-onset arterial hypertension after living kidney donation. The deterioration of renal function was higher after living kidney donation among donors with preexisting arterial hypertension. Among our cohort of 464 donors, living donation was associated with a reduction in renal function.