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Author Topic: A Prospective Controlled Study of Kidney Donors: Baseline and 6-Month Follow-up  (Read 1548 times)

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Offline Clark

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http://www.ajkd.org/article/S0272-6386(13)00492-7/abstract

A Prospective Controlled Study of Kidney Donors: Baseline and 6-Month Follow-up
Bertram L. Kasiske, MD, Teresa Anderson-Haag, PharmD, BCPS, Hassan N. Ibrahim, MD, Todd E. Pesavento, MD, Matthew R. Weir, MD, Joseph M. Nogueira, MD, Fernando G. Cosio, MD, Edward S. Kraus, MD, Hamid H. Rabb, MD, Roberto S. Kalil, MD, Andrew A. Posselt, MD, Paul L. Kimmel, MD, Michael W. Steffes, MD
American Journal of Kidney Diseases
Article in Press

Abstract

Background
Most previous studies of living kidney donors have been retrospective and have lacked suitable healthy controls. Needed are prospective controlled studies to better understand the effects of a mild reduction in kidney function from kidney donation in otherwise healthy individuals.

Study Design
Prospective, controlled, observational cohort study.

Setting & Participants
Consecutive patients approved for donation at 8 transplant centers in the United States were asked to participate. For every donor enrolled, an equally healthy control with 2 kidneys who theoretically would have been suitable to donate a kidney also was enrolled.

Predictor
Kidney donation.

Measurements
At baseline predonation and at 6 months after donation, medical history, vital signs, measured (iohexol) glomerular filtration rate, and other measurements were collected. There were 201 donors and 198 controls who completed both baseline and 6-month visits and form the basis of this report.

Results
Compared with controls, donors had 28% lower glomerular filtration rates at 6 months (94.6 ± 15.1 [SD] vs 67.6 ± 10.1 mL/min/1.73 m2; P < 0.001), associated with 23% greater parathyroid hormone (42.8 ± 15.6 vs 52.7 ± 20.9 pg/mL; P < 0.001), 5.4% lower serum phosphate (3.5 ± 0.5 vs 3.3 ± 0.5 mg/dL; P < 0.001), 3.7% lower hemoglobin (13.6 ± 1.4 vs 13.1 ± 1.2 g/dL; P < 0.001), 8.2% greater uric acid (4.9 ± 1.2 vs 5.3 ± 1.1 mg/dL; P < 0.001), 24% greater homocysteine (1.2 ± 0.3 vs 1.5 ± 0.4 mg/L; P < 0.001), and 1.5% lower high-density lipoprotein cholesterol (54.9 ± 16.4 vs 54.1 ± 13.9 mg/dL; P = 0.03) levels. There were no differences in albumin-creatinine ratios (5.0 [IQR, 4.0-6.6] vs 5.0 [IQR, 3.3-5.4] mg/g; P = 0.5), office blood pressures, or glucose homeostasis.

Limitations
Short duration of follow-up and possible bias resulting from an inability to screen controls with kidney and vascular imaging performed in donors.

Conclusions
Kidney donors have some, but not all, abnormalities typically associated with mild chronic kidney disease 6 months after donation. Additional follow-up is warranted.
Unrelated directed kidney donor in 2003, 500+ time blood & platelet donor and counting!
Rep to the OPTN/UNOS Boards of Directors & Executive, Kidney Transplantation, & Ad Hoc Public Solicitation of Organ Donors Committees 2005-2011

Offline Clark

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Unrelated directed kidney donor in 2003, 500+ time blood & platelet donor and counting!
Rep to the OPTN/UNOS Boards of Directors & Executive, Kidney Transplantation, & Ad Hoc Public Solicitation of Organ Donors Committees 2005-2011

 

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