Renal function profile in white kidney donors

The first 4 decades

Hassan N. Ibrahim, Rob Foley, Scott A Reule, Richard S Spong, Aleksandra Kukla, Naim Issa, Danielle M. Berglund, Gretchen K. Sieger, Arthur J Matas

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Previous studies reported the risk of ESRD after kidney donation, but not the renal outcomes that precede ESRD. Here, we estimated the risk of proteinuria, reduced GFR, and ESRD in 3956 white kidney donors, assessed the contribution of postdonation hypertension and diabetes to these outcomes, and developed a risk calculator. After amean6SD follow-up of 16.6611.9 years, 215 (6.1%) donors developed proteinuria.Men had a higher risk of proteinuria (hazard ratio [HR], 1.56; 95%confidence interval [95%CI], 1.18 to 2.05; P,0.001) as did those with higher bodymass index (HR, 1.10; 95%CI, 1.06 to 1.13; P,0.001). In all, 1410 (36%) donors reached an EGFR,60 ml/min per 1.73 m2, and 112 (2.8%) donors had either an EGFR,30 ml/min per 1.73 m2 or ESRD (28 donors developed ESRD). An EGFR,30 ml/min per 1.73 m2 or ESRD associated with older age (HR, 1.07; 95% CI, 1.05 to 1.09; P,0.001), higher body mass index (HR, 1.08; 95% CI, 1.04 to 1.13; P,0.001), and higher systolic BP (HR, 1.02; 95% CI, 1.00 to 1.04; P=0.01) at donation. Postdonation diabetes and hypertension associated with a fourfold higher risk of proteinuria and a .2-fold higher risk of ESRD. Models predicting proteinuria and reduced EGFR performed well (C-index 0.77-1.00). In conclusion, severe reduction in GFR and ESRD after kidney donation were uncommon and were highly associated with postdonation diabetes and hypertension. Furthermore, information available before donation may predict long-term renal outcomes in white living kidney donors.

Original languageEnglish (US)
Pages (from-to)2885-2893
Number of pages9
JournalJournal of the American Society of Nephrology
Volume27
Issue number9
DOIs
StatePublished - Jan 1 2016

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Chronic Kidney Failure
Tissue Donors
Kidney
Proteinuria
Hypertension
Confidence Intervals
Living Donors
Body Mass Index

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Renal function profile in white kidney donors : The first 4 decades. / Ibrahim, Hassan N.; Foley, Rob; Reule, Scott A; Spong, Richard S; Kukla, Aleksandra; Issa, Naim; Berglund, Danielle M.; Sieger, Gretchen K.; Matas, Arthur J.

In: Journal of the American Society of Nephrology, Vol. 27, No. 9, 01.01.2016, p. 2885-2893.

Research output: Contribution to journalArticle

Ibrahim, Hassan N. ; Foley, Rob ; Reule, Scott A ; Spong, Richard S ; Kukla, Aleksandra ; Issa, Naim ; Berglund, Danielle M. ; Sieger, Gretchen K. ; Matas, Arthur J. / Renal function profile in white kidney donors : The first 4 decades. In: Journal of the American Society of Nephrology. 2016 ; Vol. 27, No. 9. pp. 2885-2893.
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abstract = "Previous studies reported the risk of ESRD after kidney donation, but not the renal outcomes that precede ESRD. Here, we estimated the risk of proteinuria, reduced GFR, and ESRD in 3956 white kidney donors, assessed the contribution of postdonation hypertension and diabetes to these outcomes, and developed a risk calculator. After amean6SD follow-up of 16.6611.9 years, 215 (6.1{\%}) donors developed proteinuria.Men had a higher risk of proteinuria (hazard ratio [HR], 1.56; 95{\%}confidence interval [95{\%}CI], 1.18 to 2.05; P,0.001) as did those with higher bodymass index (HR, 1.10; 95{\%}CI, 1.06 to 1.13; P,0.001). In all, 1410 (36{\%}) donors reached an EGFR,60 ml/min per 1.73 m2, and 112 (2.8{\%}) donors had either an EGFR,30 ml/min per 1.73 m2 or ESRD (28 donors developed ESRD). An EGFR,30 ml/min per 1.73 m2 or ESRD associated with older age (HR, 1.07; 95{\%} CI, 1.05 to 1.09; P,0.001), higher body mass index (HR, 1.08; 95{\%} CI, 1.04 to 1.13; P,0.001), and higher systolic BP (HR, 1.02; 95{\%} CI, 1.00 to 1.04; P=0.01) at donation. Postdonation diabetes and hypertension associated with a fourfold higher risk of proteinuria and a .2-fold higher risk of ESRD. Models predicting proteinuria and reduced EGFR performed well (C-index 0.77-1.00). In conclusion, severe reduction in GFR and ESRD after kidney donation were uncommon and were highly associated with postdonation diabetes and hypertension. Furthermore, information available before donation may predict long-term renal outcomes in white living kidney donors.",
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AU - Kukla, Aleksandra

AU - Issa, Naim

AU - Berglund, Danielle M.

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