Long-Term Risks for Living Kidney Donors

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Abstract

Living kidney donation is highly beneficial to transplant recipients. However, a debate exists whether the 25-40% of GFR reduction that donors suffer after nephrectomy may adversely affect their long-term clinical outcome.

The goal of this study is to analyse the long-term medical outcome (hypertension, diabetes, kidney function, survival…) of all our living kidney donors (LKD).

Of a total of 439 Kidney transplants, 136 were from LKD and 95 had a 5-year minimum follow-up. 79p (51F, 28 M) responded to our request about their current health status and laboratory tests. We compare it with the Spanish general population (GP) based in two Cross-Sectional Multicenter studies (EROCAP 7202p and Diabet 5048p).

At the end of study, all donors are alive; the mean age and follow-up are 52 years (35-78) and 12.1 years (5-23), respectively. Only 4p (5%, IC 95% 0.3-8%) had a GFR < 60ml/min/1.73m2 vs the 21% (IC 95% 20-22) in the GP. Patients´ age and GFR decrease were significantly related (p=0.05); our patients were younger than the GP (>60 years, 24% vs 58%). The incidence of hypertension was 16.5% vs 43% in the GP and it was related with age (p=0.03). Proteinuria was 4% and uncorrelated with CRF. The incidences of dyslipidemia, diabetes and hyperuricemia were similar to those in the GP(42% vs 48%, 10% vs 16%, 20% vs 24% respectively).

LKD does not impact survival, kidney function or medical condition. The long term incidence of CRF, hypertension and proteinuria was lower in donors, probably because they were younger and healthier than the GP.

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