TY - JOUR
T1 - Causes and timing of end-stage renal disease after living kidney donation
AU - Matas, Arthur J.
AU - Berglund, Danielle M.
AU - Vock, David M.
AU - Ibrahim, Hassan N.
N1 - Funding Information:
We thank the Surgery Clinical Trials Office, at the University of Minnesota for their dedicated follow-up of living donors; Mary Knatterud for editorial review; and Stephanie Taylor for preparation of the manuscript.
Publisher Copyright:
© 2018 The American Society of Transplantation and the American Society of Transplant Surgeons
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2018/5
Y1 - 2018/5
N2 - 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.
AB - 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.
KW - clinical research/practice
KW - donor follow-up
KW - donor nephrectomy
KW - donors and donation
KW - glomerular filtration rate (GFR)
KW - health services and outcomes research
KW - hypertension/antihypertensives
KW - kidney (native) function/dysfunction
KW - kidney transplantation/nephrology
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U2 - 10.1111/ajt.14671
DO - 10.1111/ajt.14671
M3 - Article
C2 - 29369517
AN - SCOPUS:85042593670
VL - 18
SP - 1140
EP - 1150
JO - American Journal of Transplantation
JF - American Journal of Transplantation
SN - 1600-6135
IS - 5
ER -