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Causes and timing of end‐stage renal disease after living kidney donation
Author(s) -
Matas Arthur J.,
Berglund Danielle M.,
Vock David M.,
Ibrahim Hassan N.
Publication year - 2018
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.14671
Subject(s) - medicine , end stage renal disease , kidney donation , donation , nephrectomy , kidney transplantation , disease , kidney disease , diabetes mellitus , kidney , surgery , intensive care medicine , endocrinology , economics , economic growth
End‐stage renal disease ( ESRD ) is a risk after kidney donation. We sought, in a large cohort of kidney donors, to determine the causes of donor ESRD , the interval from donation to ESRD , the role of the donor/recipient relationship, and the trajectory of the estimated GFR ( eGFR ) from donation to ESRD . From 1/1/1963 thru 12/31/2015, 4030 individuals underwent living donor nephrectomy at our center, as well as ascertainment of ESRD status. Of these, 39 developed ESRD (mean age ± standard deviation [SD] at ESRD , 62.4 ± 14.1 years; mean interval between donation and ESRD , 27.1 ± 9.8 years). Donors developing ESRD were more likely to be male, as well as smokers, and younger at donation, and to have donated to a first‐degree relative. Of donors with a known cause of ESRD (n = 25), 48% was due to diabetes and/or hypertension; only 2 from a disease that would have affected 1 kidney (cancer). Of those 25 with an ascertainable ESRD cause, 4 shared a similar etiology of ESRD with their recipient. Almost universally, the change of eGFR over time was stable, until new‐onset disease (kidney or systemic). Knowledge of factors contributing to ESRD after living kidney donation can improve donor selection and counseling, as well as long‐term postdonation care.