5-Year Follow-Up After Live Donor Nephrectomy – A Prospective Cohort Study.
1Department of Surgery, Division of HPB and Transplant Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
2Department of Nephrology, Erasmus University Medical Center, Rotterdam, Netherlands
3Department of Nephrology, Radboud University Medical Center, Nijmegen, Netherlands.
Meeting: 2016 American Transplant Congress
Abstract number: A122
Keywords: Donation, Glomerular filtration rate (GFR), Kidney, Outcome
Session Information
Date: Saturday, June 11, 2016
Session Name: Poster Session A: Kidney Donor Outcomes
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Halls C&D
Background
Recently some studies have reported less favorable results after live kidney donation. We investigated therefore which donors will possibly be at risk for chronic kidney disease.
Methods
A 5-year follow-up on renal function, hypertension, and survival was performed of a prospective cohort of 190 donors after live kidney donation. A creatinine based estimated glomerular filtration rate (eGFR) was measured with the CKD-EPI formula.
Results
Clinical data was available for 176 donors. Nine donors died during follow-up due to causes unrelated to donation, and five donors were lost to follow-up.
There was a mean decrease of 31.6% in kidney function as compared with predonation levels from a mean of 91.1 to 62.4 ml/min (p<0.001) after 5-years of follow-up; at least 79 donors (48.8%) had an eGFR of <60 ml/min. Donors with a current eGFR of <60 ml/min were older at the time of donation (58.5 versus 48.5 years, p<0.001) and had a lower eGFR (81.4 versus 100.2 ml/min, p<0.001) compared with donors with a current eGFR of ≥60 ml/min. However, there was no difference in gender (p=0.546). In addition, these donors had a higher incidence of new-onset hypertension (48.1 versus 21.6%, p=0.001).
New-onset hypertensive donors were older at the time of donation (58.7 versus 50.4 years, p<0.001) with a higher BMI (27.0 versus 25.8, p=0.036), and had a higher systolic (143.3 versus 130.6 mmHg, p<0.001) and diastolic (84.9 versus 79.2 mmHg, p<0.001) blood pressure at follow-up compared to non-hypertensive donors.
There was no significant difference in protein to creatinine ratio in urine samples between donors with different eGFR classifications (p=0.406) or between new-onset hypertensive and non-hypertensive donors (p=0.968). No donors were found at risk for end-stage renal disease or renal replacement therapy.
Conclusion
These results indicate a plea for surveillance of new-onset high blood pressure after kidney donation and yearly monitoring of renal function. Future studies are indicated to identify those individuals at risk for a progressive loss of renal function after kidney donation.
CITATION INFORMATION: Janki S, Mulder E, Dols L, Betjes M, Dooper I, IJzermans J. 5-Year Follow-Up After Live Donor Nephrectomy – A Prospective Cohort Study. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Janki S, Mulder E, Dols L, Betjes M, Dooper I, IJzermans J. 5-Year Follow-Up After Live Donor Nephrectomy – A Prospective Cohort Study. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/5-year-follow-up-after-live-donor-nephrectomy-a-prospective-cohort-study/. Accessed May 21, 2019.« Back to 2016 American Transplant Congress