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Kidney Int. 2014 Jul;86(1):162-7. doi: 10.1038/ki.2013.460. Epub 2013 Nov 27.

Long-term risks for kidney donors.

Author information

  • 1Department of Transplant Medicine, Oslo University Hospital, Oslo, Norway.
  • 21] Department of Nephrology, St Olav University Hospital, Trondheim, Norway [2] Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
  • 3Norwegian Renal Registry, Department of Transplant Medicine, Oslo University Hospital, Oslo, Norway.
  • 4Department of Nephrology, St Olav University Hospital, Trondheim, Norway.
  • 5Department of Preventive Medicine, Oslo University Hospital, Oslo, Norway.
  • 6Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.

Abstract

Previous studies have suggested that living kidney donors maintain long-term renal function and experience no increase in cardiovascular or all-cause mortality. However, most analyses have included control groups less healthy than the living donor population and have had relatively short follow-up periods. Here we compared long-term renal function and cardiovascular and all-cause mortality in living kidney donors compared with a control group of individuals who would have been eligible for donation. All-cause mortality, cardiovascular mortality, and end-stage renal disease (ESRD) was identified in 1901 individuals who donated a kidney during 1963 through 2007 with a median follow-up of 15.1 years. A control group of 32,621 potentially eligible kidney donors was selected, with a median follow-up of 24.9 years. Hazard ratio for all-cause death was significantly increased to 1.30 (95% confidence interval 1.11-1.52) for donors compared with controls. There was a significant corresponding increase in cardiovascular death to 1.40 (1.03-1.91), while the risk of ESRD was greatly and significantly increased to 11.38 (4.37-29.6). The overall incidence of ESRD among donors was 302 cases per million and might have been influenced by hereditary factors. Immunological renal disease was the cause of ESRD in the donors. Thus, kidney donors are at increased long-term risk for ESRD, cardiovascular, and all-cause mortality compared with a control group of non-donors who would have been eligible for donation.

PMID:
24284516
DOI:
10.1038/ki.2013.460
[PubMed - indexed for MEDLINE]
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