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Risk of Cause-Specific ESRD in Live Kidney Donors

S. Anjum, A. Muzaale, A. Massie, S. Bae, D. Segev.

Johns Hopkins, Baltimore.

Meeting: 2015 American Transplant Congress

Abstract number: 298

Keywords: Donation, Kidney transplantation, Renal failure

Session Information

Session Name: Concurrent Session: Kidney: Living Donor Issues II

Session Type: Concurrent Session

Date: Monday, May 4, 2015

Session Time: 4:00pm-5:30pm

 Presentation Time: 4:12pm-4:24pm

Location: Terrace IV

The purpose of this study is to investigate the risk of developing cause-specific ESRD in live kidney donors over time.

METHODS: We studied a cohort of 125,451 donors in the United States between 1987-2014 from SRTR data (including left-censored observations before 1994), linked to CMS form 2728. We compared rates of cause-specific ESRD risk using Kaplan-Meier and Poisson regression analyses. Maximum follow-up was 25 years. To compare incidence rate differences, we split this follow-up time into two groups: 0-10 years (era 1) and 10+ years (era 2). We adjusted for age, sex, and race. Age was modeled separately for each era such that the association between older age and risk of disease did not impact the incidence rate ratio models.

RESULTS: Unadjusted cumulative incidence of ESRD was 84 per 10,000 in donors 25 years post-donation (Figure 1). After adjustment, donors in era 2 had a higher incidence rate ratio (3.3 4.4 5.8) vs. era 1. Similarly, in the diabetes(4.9 17 56)-, hypertension(3.9 7.0 13)-, glomerulonephritis(1.4 2.5 4.4)-, and others(1.9 3.1 5.1)-specific ESRD models, donors have an increased risk of ESRD in era 2 vs. era 1 (Table 1).

CONCLUSIONS: Donor risk for ESRD increases dramatically ten years post donation, particularly diabetes and hypertension specific ESRD (Figure 2).

Table 1: Incidence of ESRD in Kidney Donors
  cases n (%) Crude, Cumulative Incidence at 25 Years (per 10K) IRR (AA) IRR (female) IRR (age per 1y) IRR (>10y vs. 0-9y)
All-cause 234 71 84 99 3.4 4.3 5.6 0.4 0.5 1.86 1.00 1.02 1.03 3.3 4.4 5.8
Cause-specific
Diabetes 32 (14) 10 15 23 1.9 4.1 8.6 0.1 0.2 0.4 1.0 1.03 1.06 4.9 17 56
Hypertension 70 (30) 20 28 39 2.1 3.4 5.7 0.3 0.5 0.8 0.99 1.0 1.03 3.9 7.0 13
Glomerulonephritis 55 (23) 10 14 19 4.4 7.6 13 0.4 0.6 1.1 0.96 0.99 1.01 1.4 2.5 4.4
Other 77 (33) 22 29 37 1.8 2.9 4.9 0.4 0.6 0.9 1.01 1.03 1.05 1.9 3.1 5.1
Adjusted for age (centered at 40 years), ethnicity (African American vs. Other), and sex at donation.
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To cite this abstract in AMA style:

Anjum S, Muzaale A, Massie A, Bae S, Segev D. Risk of Cause-Specific ESRD in Live Kidney Donors [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/risk-of-cause-specific-esrd-in-live-kidney-donors/. Accessed May 10, 2025.

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