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June 14, 2022
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Researchers explore the 25-year risk of ESKD among living kidney donors

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An assessment of the 25-year risk of end-stage kidney disease among living kidney donors revealed different risks for different groups of donors, according to data presented at the American Transplant Congress.

“Our project assessed the risk of ESKD among living kidney donors who donated up to 25 years ago. Previous research has found that living kidney donation is generally safe, but the best long-term data on the topic are based on a cohort of primarily white donors,” Jennifer Wainright, PhD, a senior research scientist at the United Network for Organ Sharing, told Healio “This research uses a national cohort and allows us to report longer-term outcomes for a more diverse group of donors.”

Researchers evaluated the 25-year risk of ESKD after donation among 145,457 living kidney donors who donated between April 1, 1994, and March 31, 2020. All ESKD cases were confirmed with Organ Procurement and Transplantation Network (OPTN) and CMS data.

Using Kaplan-Meier methodology, researchers determined cumulative incidence of overall ESKD and by donor, sex, race, relationship and socioeconomic status. Researchers identified 381 living kidney donors who developed ESKD by March 31, 2020.

Analyses revealed the overall cumulative incidence of ESKD 25 years after donation was 98.1 per 10,000 living kidney donors. However, differences among groups occurred at a great magnitude between the 20- and 25-year mark after donations. For example, researchers noticed the cumulative incidence for Black living kidney donors increased from 111.3 at 20 years to 235.7 at 25 years, whereas other racial groups did not show as significant of increases.

Similarly, male living kidney donors showed a substantial cumulative incidence increase from 69.4 at 20 years to 136 at 25 years, but women did not. Additional groups that showed significant cumulative incidence increases from 20 to 25 years after donation included first-degree relatives of recipients and those in the lowest quartile of neighborhood income.

“Our results emphasize the importance of transplant teams working with potential living kidney donors to help them make informed decisions based on their specific situations,” Wainwright told Healio. “The OPTN will continue to assess the safety of living kidney donation as more long-term data become available.”