We studied development of End Stage Renal Disease (ESRD) in living kidney donors (LKDs) who donated in the US between 1994 and 2016 (n=123,523), using Organ Procurement and Transplantation Network (OPTN) and Centers for Medicare and Medicaid Services (CMS) data. 219 LKDs developed ESRD through 9/30/16, with a median of 11.1 years between donation and ESRD. Absolute risk of ESRD was low but not uniform, with risk associated with race, age, and sex. In multivariable analyses, LKDs had increased risk of ESRD if they were male (adjusted Hazard Ratio (aHR): 1.76, 95% Confidence Interval (95%CI): 1.32-2.34) or had higher BMI (aHR: 1.33, 95%CI: 1.06-1.66). First degree relatives of the recipient had higher risk than unrelated LKDs (parent: (aHR: 2.04, 95% CI: 1.28-3.26); full sibling (aHR: 1.90, 95%CI: 1.25-2.89); identical twin (aHR: 20.24, 95%CI: 7.77-52.72)). We found higher risk for LKDs who lived in lower SES neighborhoods at donation (aHR: 0.87 per $10k increase; 95%CI: 0.77-0.99), and a significant interaction between age and race, with higher risk for white LKDs at older ages (aHR: 1.26 per decade, 95%CI: 1.02-1.54), but higher risk for black LKDs at younger ages (aHR: 0.75, 95%CI: 0.57-0.99). These findings further inform risk assessment of potential LKDs.

CITATION INFORMATION: Wainright J., Robinson A., Wilk A., Klassen D., Cherikh W., Stewart D. Risk of ESRD in Prior Living Kidney Donors Am J Transplant. 2017;17 (suppl 3).

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