A prospective controlled study of kidney donors

Baseline and 6-month follow-up

Bert L Kasiske, Teresa Anderson-Haag, Hassan N. Ibrahim, Todd E. Pesavento, Matthew R. Weir, Joseph M. Nogueira, Fernando G. Cosio, Edward S. Kraus, Hamid H. Rabb, Roberto S. Kalil, Andrew A. Posselt, Paul L. Kimmel, Michael W Steffes

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Background: Most previous studies of living kidney donors have been retrospective and have lacked suitable healthy controls. Needed are prospective controlled studies to better understand the effects of a mild reduction in kidney function from kidney donation in otherwise healthy individuals. Study Design: Prospective, controlled, observational cohort study. Setting & Participants: Consecutive patients approved for donation at 8 transplant centers in the United States were asked to participate. For every donor enrolled, an equally healthy control with 2 kidneys who theoretically would have been suitable to donate a kidney also was enrolled. Predictor: Kidney donation. Measurements: At baseline predonation and at 6 months after donation, medical history, vital signs, measured (iohexol) glomerular filtration rate, and other measurements were collected. There were 201 donors and 198 controls who completed both baseline and 6-month visits and form the basis of this report. Results: Compared with controls, donors had 28% lower glomerular filtration rates at 6 months (94.6 ± 15.1 [SD] vs 67.6 ± 10.1 mL/min/1.73 m 2 ; P < 0.001), associated with 23% greater parathyroid hormone (42.8 ± 15.6 vs 52.7 ± 20.9 pg/mL; P < 0.001), 5.4% lower serum phosphate (3.5 ± 0.5 vs 3.3 ± 0.5 mg/dL; P < 0.001), 3.7% lower hemoglobin (13.6 ± 1.4 vs 13.1 ± 1.2 g/dL; P < 0.001), 8.2% greater uric acid (4.9 ± 1.2 vs 5.3 ± 1.1 mg/dL; P < 0.001), 24% greater homocysteine (1.2 ± 0.3 vs 1.5 ± 0.4 mg/L; P < 0.001), and 1.5% lower high-density lipoprotein cholesterol (54.9 ± 16.4 vs 54.1 ± 13.9 mg/dL; P = 0.03) levels. There were no differences in albumin-creatinine ratios (5.0 [IQR, 4.0-6.6] vs 5.0 [IQR, 3.3-5.4] mg/g; P = 0.5), office blood pressures, or glucose homeostasis. Limitations: Short duration of follow-up and possible bias resulting from an inability to screen controls with kidney and vascular imaging performed in donors. Conclusions: Kidney donors have some, but not all, abnormalities typically associated with mild chronic kidney disease 6 months after donation. Additional follow-up is warranted.

Original languageEnglish (US)
Pages (from-to)577-586
Number of pages10
JournalAmerican Journal of Kidney Diseases
Volume62
Issue number3
DOIs
StatePublished - Sep 1 2013

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Tissue Donors
Prospective Studies
Kidney
Glomerular Filtration Rate
Iohexol
Vital Signs
Living Donors
Homocysteine
Uric Acid
Parathyroid Hormone
Chronic Renal Insufficiency
HDL Cholesterol
Observational Studies
Blood Vessels
Blood Glucose
Albumins
Creatinine
Hemoglobins
Homeostasis
Cohort Studies

Keywords

  • Chronic kidney disease
  • glomerular filtration rate
  • mineral and bone disorders
  • patient safety
  • unilateral nephrectomy

Cite this

Kasiske, B. L., Anderson-Haag, T., Ibrahim, H. N., Pesavento, T. E., Weir, M. R., Nogueira, J. M., ... Steffes, M. W. (2013). A prospective controlled study of kidney donors: Baseline and 6-month follow-up. American Journal of Kidney Diseases, 62(3), 577-586. https://doi.org/10.1053/j.ajkd.2013.01.027

A prospective controlled study of kidney donors : Baseline and 6-month follow-up. / Kasiske, Bert L; Anderson-Haag, Teresa; Ibrahim, Hassan N.; Pesavento, Todd E.; Weir, Matthew R.; Nogueira, Joseph M.; Cosio, Fernando G.; Kraus, Edward S.; Rabb, Hamid H.; Kalil, Roberto S.; Posselt, Andrew A.; Kimmel, Paul L.; Steffes, Michael W.

In: American Journal of Kidney Diseases, Vol. 62, No. 3, 01.09.2013, p. 577-586.

Research output: Contribution to journalArticle

Kasiske, BL, Anderson-Haag, T, Ibrahim, HN, Pesavento, TE, Weir, MR, Nogueira, JM, Cosio, FG, Kraus, ES, Rabb, HH, Kalil, RS, Posselt, AA, Kimmel, PL & Steffes, MW 2013, 'A prospective controlled study of kidney donors: Baseline and 6-month follow-up', American Journal of Kidney Diseases, vol. 62, no. 3, pp. 577-586. https://doi.org/10.1053/j.ajkd.2013.01.027
Kasiske BL, Anderson-Haag T, Ibrahim HN, Pesavento TE, Weir MR, Nogueira JM et al. A prospective controlled study of kidney donors: Baseline and 6-month follow-up. American Journal of Kidney Diseases. 2013 Sep 1;62(3):577-586. https://doi.org/10.1053/j.ajkd.2013.01.027
Kasiske, Bert L ; Anderson-Haag, Teresa ; Ibrahim, Hassan N. ; Pesavento, Todd E. ; Weir, Matthew R. ; Nogueira, Joseph M. ; Cosio, Fernando G. ; Kraus, Edward S. ; Rabb, Hamid H. ; Kalil, Roberto S. ; Posselt, Andrew A. ; Kimmel, Paul L. ; Steffes, Michael W. / A prospective controlled study of kidney donors : Baseline and 6-month follow-up. In: American Journal of Kidney Diseases. 2013 ; Vol. 62, No. 3. pp. 577-586.
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abstract = "Background: Most previous studies of living kidney donors have been retrospective and have lacked suitable healthy controls. Needed are prospective controlled studies to better understand the effects of a mild reduction in kidney function from kidney donation in otherwise healthy individuals. Study Design: Prospective, controlled, observational cohort study. Setting & Participants: Consecutive patients approved for donation at 8 transplant centers in the United States were asked to participate. For every donor enrolled, an equally healthy control with 2 kidneys who theoretically would have been suitable to donate a kidney also was enrolled. Predictor: Kidney donation. Measurements: At baseline predonation and at 6 months after donation, medical history, vital signs, measured (iohexol) glomerular filtration rate, and other measurements were collected. There were 201 donors and 198 controls who completed both baseline and 6-month visits and form the basis of this report. Results: Compared with controls, donors had 28{\%} lower glomerular filtration rates at 6 months (94.6 ± 15.1 [SD] vs 67.6 ± 10.1 mL/min/1.73 m 2 ; P < 0.001), associated with 23{\%} greater parathyroid hormone (42.8 ± 15.6 vs 52.7 ± 20.9 pg/mL; P < 0.001), 5.4{\%} lower serum phosphate (3.5 ± 0.5 vs 3.3 ± 0.5 mg/dL; P < 0.001), 3.7{\%} lower hemoglobin (13.6 ± 1.4 vs 13.1 ± 1.2 g/dL; P < 0.001), 8.2{\%} greater uric acid (4.9 ± 1.2 vs 5.3 ± 1.1 mg/dL; P < 0.001), 24{\%} greater homocysteine (1.2 ± 0.3 vs 1.5 ± 0.4 mg/L; P < 0.001), and 1.5{\%} lower high-density lipoprotein cholesterol (54.9 ± 16.4 vs 54.1 ± 13.9 mg/dL; P = 0.03) levels. There were no differences in albumin-creatinine ratios (5.0 [IQR, 4.0-6.6] vs 5.0 [IQR, 3.3-5.4] mg/g; P = 0.5), office blood pressures, or glucose homeostasis. Limitations: Short duration of follow-up and possible bias resulting from an inability to screen controls with kidney and vascular imaging performed in donors. Conclusions: Kidney donors have some, but not all, abnormalities typically associated with mild chronic kidney disease 6 months after donation. Additional follow-up is warranted.",
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author = "Kasiske, {Bert L} and Teresa Anderson-Haag and Ibrahim, {Hassan N.} and Pesavento, {Todd E.} and Weir, {Matthew R.} and Nogueira, {Joseph M.} and Cosio, {Fernando G.} and Kraus, {Edward S.} and Rabb, {Hamid H.} and Kalil, {Roberto S.} and Posselt, {Andrew A.} and Kimmel, {Paul L.} and Steffes, {Michael W}",
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T1 - A prospective controlled study of kidney donors

T2 - Baseline and 6-month follow-up

AU - Kasiske, Bert L

AU - Anderson-Haag, Teresa

AU - Ibrahim, Hassan N.

AU - Pesavento, Todd E.

AU - Weir, Matthew R.

AU - Nogueira, Joseph M.

AU - Cosio, Fernando G.

AU - Kraus, Edward S.

AU - Rabb, Hamid H.

AU - Kalil, Roberto S.

AU - Posselt, Andrew A.

AU - Kimmel, Paul L.

AU - Steffes, Michael W

PY - 2013/9/1

Y1 - 2013/9/1

N2 - Background: Most previous studies of living kidney donors have been retrospective and have lacked suitable healthy controls. Needed are prospective controlled studies to better understand the effects of a mild reduction in kidney function from kidney donation in otherwise healthy individuals. Study Design: Prospective, controlled, observational cohort study. Setting & Participants: Consecutive patients approved for donation at 8 transplant centers in the United States were asked to participate. For every donor enrolled, an equally healthy control with 2 kidneys who theoretically would have been suitable to donate a kidney also was enrolled. Predictor: Kidney donation. Measurements: At baseline predonation and at 6 months after donation, medical history, vital signs, measured (iohexol) glomerular filtration rate, and other measurements were collected. There were 201 donors and 198 controls who completed both baseline and 6-month visits and form the basis of this report. Results: Compared with controls, donors had 28% lower glomerular filtration rates at 6 months (94.6 ± 15.1 [SD] vs 67.6 ± 10.1 mL/min/1.73 m 2 ; P < 0.001), associated with 23% greater parathyroid hormone (42.8 ± 15.6 vs 52.7 ± 20.9 pg/mL; P < 0.001), 5.4% lower serum phosphate (3.5 ± 0.5 vs 3.3 ± 0.5 mg/dL; P < 0.001), 3.7% lower hemoglobin (13.6 ± 1.4 vs 13.1 ± 1.2 g/dL; P < 0.001), 8.2% greater uric acid (4.9 ± 1.2 vs 5.3 ± 1.1 mg/dL; P < 0.001), 24% greater homocysteine (1.2 ± 0.3 vs 1.5 ± 0.4 mg/L; P < 0.001), and 1.5% lower high-density lipoprotein cholesterol (54.9 ± 16.4 vs 54.1 ± 13.9 mg/dL; P = 0.03) levels. There were no differences in albumin-creatinine ratios (5.0 [IQR, 4.0-6.6] vs 5.0 [IQR, 3.3-5.4] mg/g; P = 0.5), office blood pressures, or glucose homeostasis. Limitations: Short duration of follow-up and possible bias resulting from an inability to screen controls with kidney and vascular imaging performed in donors. Conclusions: Kidney donors have some, but not all, abnormalities typically associated with mild chronic kidney disease 6 months after donation. Additional follow-up is warranted.

AB - Background: Most previous studies of living kidney donors have been retrospective and have lacked suitable healthy controls. Needed are prospective controlled studies to better understand the effects of a mild reduction in kidney function from kidney donation in otherwise healthy individuals. Study Design: Prospective, controlled, observational cohort study. Setting & Participants: Consecutive patients approved for donation at 8 transplant centers in the United States were asked to participate. For every donor enrolled, an equally healthy control with 2 kidneys who theoretically would have been suitable to donate a kidney also was enrolled. Predictor: Kidney donation. Measurements: At baseline predonation and at 6 months after donation, medical history, vital signs, measured (iohexol) glomerular filtration rate, and other measurements were collected. There were 201 donors and 198 controls who completed both baseline and 6-month visits and form the basis of this report. Results: Compared with controls, donors had 28% lower glomerular filtration rates at 6 months (94.6 ± 15.1 [SD] vs 67.6 ± 10.1 mL/min/1.73 m 2 ; P < 0.001), associated with 23% greater parathyroid hormone (42.8 ± 15.6 vs 52.7 ± 20.9 pg/mL; P < 0.001), 5.4% lower serum phosphate (3.5 ± 0.5 vs 3.3 ± 0.5 mg/dL; P < 0.001), 3.7% lower hemoglobin (13.6 ± 1.4 vs 13.1 ± 1.2 g/dL; P < 0.001), 8.2% greater uric acid (4.9 ± 1.2 vs 5.3 ± 1.1 mg/dL; P < 0.001), 24% greater homocysteine (1.2 ± 0.3 vs 1.5 ± 0.4 mg/L; P < 0.001), and 1.5% lower high-density lipoprotein cholesterol (54.9 ± 16.4 vs 54.1 ± 13.9 mg/dL; P = 0.03) levels. There were no differences in albumin-creatinine ratios (5.0 [IQR, 4.0-6.6] vs 5.0 [IQR, 3.3-5.4] mg/g; P = 0.5), office blood pressures, or glucose homeostasis. Limitations: Short duration of follow-up and possible bias resulting from an inability to screen controls with kidney and vascular imaging performed in donors. Conclusions: Kidney donors have some, but not all, abnormalities typically associated with mild chronic kidney disease 6 months after donation. Additional follow-up is warranted.

KW - Chronic kidney disease

KW - glomerular filtration rate

KW - mineral and bone disorders

KW - patient safety

KW - unilateral nephrectomy

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