Background:

The evidence linking kidney donation to a slightly increased risk of ESRD has now been accepted. The underlying causes of ESRD majority of donors who went on to develop ESRD are diabetes and hypertension. Models that predict this risk have not been developed. More importantly, models predicting the intermediate risks of hypertension, diabetes, proteinuria, reduced GFR and even death cannot be developed using national databases.

Methods:

To address this we studied 4,187 donors who donated between 1963-2013 and had complete baseline laboratory and demographic data and also serial outcome data that included vital status, development of diabetes, hypertension, proteinuria and serum creatinine. This cohort was divided into a development set and a validation set after a model predicting these outcomes was developed using over 20 baseline variables. Models were developed to predict the 10-, 20-, 30-, 40- and 50-year risks of these complications.

Results:

The two sets were comparable on all characteristics [Table 1]. There were 346 deaths, 260 diabetes cases, 988 hypertension cases, 220 proteinuria cases and 173 donors with eGFR < 45 ml/min. The C statistic varied from 0.77-0.88 for outcomes below.

Conclusion:

Herein we provide a tool that clinicians can use to discuss risks associated with kidney donation with potential kidney donors using available clinical information.

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