The 2017 KDIGO guidelines recommend that living kidney donors receive lifelong annual follow-up care to assess renal health, including serum creatinine measurements with glomerular filtration rate estimation and albuminuria measurement. Whether these best practice recommendations are currently being followed is unclear.

We conducted a retrospective study using linked databases in Alberta, Canada to identify and follow living kidney donors from 2002 to 2014. We determined the proportion of donors who had an annual outpatient physician visit and outpatient laboratory measurements for serum creatinine and albuminuria (urinalysis, protein-creatinine ratio, or albumin-creatinine ratio).

There were 534 living kidney donors with a median follow-up of 6.5 years (maximum 12.5 years). The median age at the time of donation was 41.5 years and 62% were female. Overall, 25% of donors had all three markers of care (physician visit, serum creatinine, and albuminuria measurement) in each year of follow-up. Adherence to annual physician visits was higher than serum creatinine or albuminuria measurements (67% vs. 32% vs. 29% of donors, respectively). In adjusted analyses, compared to donors who did not have guideline-concordant follow-up care, donors with guideline-concordant care were more likely to be older, resided closer to the transplant center, and received their nephrectomy in more recent years.

These findings suggest significant evidence-practice gaps, in that the majority of living kidney donors saw a physician annually, but the minority had measurements of kidney function or albuminuria. Future interventions should target improving follow-up care for all donors.

CITATION INFORMATION: Lam N., Lentine K., Hemmelgarn B., Klarenbach S., Quinn R., Lloyd A., Gourishankar S., Garg A. Follow-Up Care of Living Kidney Donors Am J Transplant. 2017;17 (suppl 3).

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