Long-term Outcomes of Living Kidney Donors – A Single Centre Experience of 29 Ye

[Clark]

http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1797.2011.01524.x/abstract

Long-term Outcomes of Living Kidney Donors – A Single Centre Experience of 29 Years
Dr Kwok-hong CHU, Dr Clara Ka-yan POON, Dr Chung-man LAM, Dr Au CHEUK, Dr Ka-fai YIM, Dr William LEE, Dr Hon-lok TANG, Dr Hilda Wai-han CHAN, Dr Ka-shun FUNG, Dr Kwok-lung TONG
DOI: 10.1111/j.1440-1797.2011.01524.x
Nephrology
Accepted Article (Accepted, unedited articles published online for future issues)

Abstract
Introduction:  Living kidney donation provides the best source of kidney graft. The mortality and morbidity rates are small but the long-term effects have not been studied. This is a report on our 29-year experience of living kidney donation.

Methods:  All living donors were arranged to have follow-ups. Defaulters were traced via a territory-wide computer system.

Results:  149 living kidney donor operations were performed. 136/149 records were available. 41 defaulted follow-up. One donor died of multiple myeloma. The male to female ratio was 1.00 to 1.52. Mean age at donation was 33.94 +/- 9.66 years. Mean follow-up duration was 160.39 +/- 87.96 months. Hypertension was diagnosed in 27 donors (19.9%). 22 donors (17.3%) had stage 3 chronic kidney disease (CKD). GFR dropped from 90.95 +/- 15.62 ml/min/1.73m2 at time 0 to 66.29 +/- 12.06 ml/min/1.73m2 at 2 years. GFR improved subsequently and remained stable for 25 years. Age at donation was associated with HT in univariate and multivariate analyses. HT was not associated with sex or GFRs over time. Using binary logistic regression, age at donation was associated with the development of stage 3 CKD and GFR before donation was associated with lower CKD risk. In multivariate analysis, only age at donation was associated with CKD. Other co-morbidities included: hyperlipidaemia 16/136, DM 6/136, cardiovascular event 1/136, stroke 1/136 and cancer 5/136.

Conclusions:  Living kidney donors had reductions in GFR post uninephrectomy with subsequent improvement. A significant proportion developed HT and stage 3 CKD. Age at donation was a strong determinant of development of HT and stage 3 CKD.