https://www.sciencedirect.com/science/article/pii/S2468024926029220
This research paper uses data from the Swiss Organ Living-Donor Health Registry to provide insights into the long-term consequences of living kidney donation. Unfortunately, there is no health-matched control group for comparison purposes, so we get only results for LKDs without a standard of comparison.
Here are the main observations from the study:
- Long-term kidney function after donation remains "excellent"; the median eGFR was in GFR category 2 (GFR 89 - 60) and remained stable over the 30 year measurement period
- 0.9% of donors had an eGFR less than 30 (End Stage Renal Disease)
- 0.2% of donors had kidney failure requiring dialysis
- "Thus, isolated postdonation reductions in GFR should not be interpreted as CKD. Importantly, KDIGO GFR categories were developed for populations with intrinsic kidney disease and are not directly applicable to otherwise healthy individuals who have undergone nephrectomy. In the absence of additional markers of kidney damage, such as proteinuria or progressive functional decline, reduced GFR after donation should not be equated with progressive CKD."
- "...donor comorbidities (obesity, hypertension, etc.) rather than nephrectomy per se appear to drive long-term renal risk."
- "These findings support predonation hypertension as an important determinant of late adverse renal outcomes."
- "These findings underscore that long-term donor safety is not solely determined by baseline donor selection but also by the availability of sustained postdonation care...."