Reassessing Medical Risk in Living Kidney Donors

[Clark]

http://jasn.asnjournals.org/content/early/2014/09/24/ASN.2014030227.abstract

Reassessing Medical Risk in Living Kidney Donors
Robert S. Gaston*, Vineeta Kumar* and Arthur J. Matas†
Published online before print
doi: 10.1681/ASN.2014030227
JASN September 25, 2014 ASN.2014030227

Correspondence:
Dr. Robert S. Gaston, Division of Nephrology, University of Alabama at Birmingham, 1900 University Boulevard, 625 THT, Birmingham, Alabama 35294. Email: rgaston@uab.edu

Abstract

The short- and long-term effects of unilateral nephrectomy on living donors have been important considerations for 60 years. Short-term risk is well established (0.03% mortality and <1% risk of major morbidity), but characterization of long-term risk is evolving. Relative to the general population, risk of mortality, ESRD, hypertension, proteinuria, and cardiovascular disease is comparable or lower. However, new studies comparing previous donors with equally healthy controls indicate increased risk of metabolic derangements (particularly involving calcium homeostasis), renal failure, and possibly, mortality. We discuss how these results should be interpreted and their influence on the practice of living donor kidney transplantation.