Causes and timing of end-stage renal disease after living kidney donation

Arthur J. Matas, Danielle M. Berglund, David M. Vock, Hassan N. Ibrahim

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

End-stage renal disease (ESRD) is a risk after kidney donation. We sought, in a large cohort of kidney donors, to determine the causes of donor ESRD, the interval from donation to ESRD, the role of the donor/recipient relationship, and the trajectory of the estimated GFR (eGFR) from donation to ESRD. From 1/1/1963 thru 12/31/2015, 4030 individuals underwent living donor nephrectomy at our center, as well as ascertainment of ESRD status. Of these, 39 developed ESRD (mean age ± standard deviation [SD] at ESRD, 62.4 ± 14.1 years; mean interval between donation and ESRD, 27.1 ± 9.8 years). Donors developing ESRD were more likely to be male, as well as smokers, and younger at donation, and to have donated to a first-degree relative. Of donors with a known cause of ESRD (n = 25), 48% was due to diabetes and/or hypertension; only 2 from a disease that would have affected 1 kidney (cancer). Of those 25 with an ascertainable ESRD cause, 4 shared a similar etiology of ESRD with their recipient. Almost universally, thechange of eGFR over time was stable, until new-onset disease (kidney or systemic). Knowledge of factors contributing to ESRD after living kidney donation can improve donor selection and counseling, as well as long-term postdonation care.

Original languageEnglish (US)
Pages (from-to)1140-1150
Number of pages11
JournalAmerican Journal of Transplantation
Volume18
Issue number5
DOIs
StatePublished - May 2018

Keywords

  • clinical research/practice
  • donor follow-up
  • donor nephrectomy
  • donors and donation
  • glomerular filtration rate (GFR)
  • health services and outcomes research
  • hypertension/antihypertensives
  • kidney (native) function/dysfunction
  • kidney transplantation/nephrology

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