Study: Some kidney donors may develop low eGFR, albuminuria after donation
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Key takeaways:
- Overall, 47 donors in the study developed sustained low eGFR or moderate-severe albuminuria.
- Median time for the outcome beyond the first year after nephrectomy was 2.9 years.
A percentage of kidney donors may develop low eGFR or albuminuria after donation, according to a recently published retrospective, population-based cohort study.
“Although donor nephrectomy is considered relatively safe, there are potential short- and long-term risks for donors,” Anisha Dhalla, MD, of the nephrology division at the University of Calgary in Canada, wrote with colleagues. “We determined the incidence and risk factors associated with developing low eGFR and moderate-severe albuminuria.”
Researchers identified 590 adult living kidney donors who underwent donor nephrectomy between 2001 and 2017 in Alberta, Canada, and matched study criteria for inclusion. Primary outcomes included two eGFR measurements less than than 45 mL/min/1.73 m2 or two of moderate or severe albuminuria from 1 year after donation onward that were at least 90 days apart.
According to results, 47 donors developed sustained low eGFR or moderate-severe albuminuria during a median follow-up of 8.6 years, at an incidence rate of 9.2 per 1,000 person-years. Median time for the outcome beyond the first year after nephrectomy was 2.9 years, according to the results.
Dhalla and colleagues noted donors with lower pre-donation eGFR of 5 mL/min/1.73 m2 lower had a 26% increased hazard of developing post-donation low eGFR or moderate-severe albuminuria within the first 4 years of follow-up. Pre-donation hypertension and post-donation diabetes also amplified risk of developing low eGFR or albuminuria.
Limitations included a lack of data on certain donor traits, like race, smoking and transplant history, that may impact long-term kidney function, the authors noted.
“Further research is needed to determine if donors with these risk factors would benefit from more diligent follow-up care as well as the impact of low eGFR and moderate-severe albuminuria on donor morbidity,” Dhalla and colleagues wrote.
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