TY - JOUR
T1 - Long-Term Non–End-Stage Renal Disease Risks After Living Kidney Donation
AU - Matas, A. J.
AU - Hays, R. E.
AU - Ibrahim, H. N.
N1 - Publisher Copyright:
© Copyright 2016 The American Society of Transplantation and the American Society of Transplant Surgeons
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Despite generally positive outcomes and high rates of satisfaction, living kidney donors are at risk for both medical and psychosocial problems. In this review, the authors summarize non–end-stage renal disease (ESRD) risks for donors and describe limitations to the data. We review the evidence of medical risks (e.g. increased cardiovascular disease and mortality, preeclampsia) and psychosocial risks (e.g. mood disturbance, financial burden). We then discuss the evidence of differential risks among subsets and the impact of postdonation events (e.g. development of diabetes). Collectively, available evidence indicates the following. (1) Recognizing the importance of non-ESRD risks has been overshadowed by analyses of the reported risk of ESRD. This imbalance should be remedied. (2) There is little quantification of the true contribution of donation to medical and psychosocial outcomes. (3) Most studies, to date, have been retrospective, with limited sample sizes and diversity and with less-than-ideal controls for comparison of outcomes. (4) Many postdonation events (diabetes and hypertension) can now be reasonably predicted, and their association with adverse outcomes can be quantified. (5) Mechanisms and systems need to be implemented to evaluate and care for donors who develop medical and/or psychosocial problems. (6) Costs to donors are a significant burden, and making donation financially neutral should be a priority.
AB - Despite generally positive outcomes and high rates of satisfaction, living kidney donors are at risk for both medical and psychosocial problems. In this review, the authors summarize non–end-stage renal disease (ESRD) risks for donors and describe limitations to the data. We review the evidence of medical risks (e.g. increased cardiovascular disease and mortality, preeclampsia) and psychosocial risks (e.g. mood disturbance, financial burden). We then discuss the evidence of differential risks among subsets and the impact of postdonation events (e.g. development of diabetes). Collectively, available evidence indicates the following. (1) Recognizing the importance of non-ESRD risks has been overshadowed by analyses of the reported risk of ESRD. This imbalance should be remedied. (2) There is little quantification of the true contribution of donation to medical and psychosocial outcomes. (3) Most studies, to date, have been retrospective, with limited sample sizes and diversity and with less-than-ideal controls for comparison of outcomes. (4) Many postdonation events (diabetes and hypertension) can now be reasonably predicted, and their association with adverse outcomes can be quantified. (5) Mechanisms and systems need to be implemented to evaluate and care for donors who develop medical and/or psychosocial problems. (6) Costs to donors are a significant burden, and making donation financially neutral should be a priority.
KW - clinical research/practice
KW - donors and donation
KW - donors and donation: donor follow-up
KW - donors and donation: living
KW - health services and outcomes research
KW - kidney transplantation/nephrology
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U2 - 10.1111/ajt.14011
DO - 10.1111/ajt.14011
M3 - Review article
C2 - 27529688
AN - SCOPUS:84992500382
VL - 17
SP - 893
EP - 900
JO - American Journal of Transplantation
JF - American Journal of Transplantation
SN - 1600-6135
IS - 4
ER -