An increased risk of ESRD has been reported for living kidney donors, and appears to be higher for those donating to a relative. The reasons for this are not clear. One possibility is that ESRD is due to the nephrectomy-related reduction in GFR, followed by an age-related decline that may be more rapid in related donors. Between 1/1/1990 and 12/31/2014, we did 2002 living donor nephrectomies. We compared long-term postdonation eGFR trajectory for donors with (n = 1245) vs. without (n = 757) a first-degree relative with ESRD. Linear mixed-effects models were used to model the longitudinal trajectory of eGFR. With all other variables held constant, we noted a steady average increase in eGFR until donors reached age 70: 1.12 (95% CI: 0.92-1.32) mL/min/1.73m ² /yr between 6 weeks and 5 years postdonation; 0.24 (0.00-0.49) mL/min/1.73m ² /yr between 5 and 10 years; and 0.07 (−0.10 to +0.25) mL/min/1.73m ² /yr between 10 and 20 years for donors with attained age less than 70. After age 70, eGFR declined. After we adjusted for predonation factors, the difference in eGFR slopes between related and unrelated donors was 0.20 mL/min/1.753 m 2 /year (0.07-0.33). Our data suggests that postdonation, kidney donor eGFR increases each year for a number of years and that eGFR trajectory does not explain any increase in ESRD after donation.
Bibliographical noteFunding Information:
We thank the Surgery Clinical Trials Office, University of Minnesota and Danielle Bergland for their dedicated follow-up of living donors; Dr. Robert Steiner for review of the manuscript; Mary Knatterud for editorial assistance; and Stephanie Taylor for preparation of the manuscript. Funding for long-term donor follow-up has come from NIH DK-13083. The funding source had no role in study design or in collection, analysis, and interpretation of the data.
© 2017 The American Society of Transplantation and the American Society of Transplant Surgeons
- clinical research/practice
- donors and donation
- glomerular filtration rate (GFR)
- health services and outcomes research
- kidney transplantation/nephrology
- organ transplantation