Living Kidney Donors Facing More Rapid Declines in Renal Function

SEATTLE—Living kidney donors in recent years have experienced greater declines in renal function in the first year following nephrectomy, researchers reported at the 2013 American Transplant Congress.

In 2004, living kidney donors experienced a median 23.3 mL/min/1.73 m2 decline in estimated glomerular filtration rate (eGFR) from before donation to one-year post-nephrectomy. In 2010, the median decline was 31.9 mL/min/1.73 m2.

The findings are based on a study of 31,168 living kidney donors in the Scientific Registry of Transplant Recipients by Emily Heaphy, MD, and colleagues at Cleveland Clinic. The study sample was 70.3% white and 11.9% black and had a median age of 41 years. The group included 13,978 male and 21,190 female donors. Prior to donation, the overall proportion of living kidney donors with an eGFR below 60 was 3.7%; this increased to 46.8% at one year post-donation.

The study showed that changes in first-year renal function in living kidney donors are influenced significantly by demographic factors. For example, overall, the first-year median decline in eGFR was 32.3 mL/min/1.73 m2 for black donors compared with 28.1 mL/min/1.73 m2 for non-black donors.

Additionally, the proportion of living kidney donors with an eGFR below 60 was highest among whites (54%) and among donors older than 50 (66%). Men had significantly greater median increases in serum creatinine than women (0.38 vs. 0.30 mg/dL).

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