CKD Develops in Many Living Kidney Donors
Nilay Patel, MD
VIENNA—One year after undergoing living donor nephrectomy (LDN), more than half of donors will have chronic kidney disease (CKD), according to a British study. Their decline in renal function, however, appears to remain stable for at least five years and patients rarely suffer adverse cardiovascular events and cardiac mortality.
In the study, a team led by Nilay S. Patel, MD, a urology resident at The Churchill Hospital, examined data from 3,424 patients who underwent LDN in the United Kingdom and had preoperative and one-year follow-up data available. Complete post-operative follow-up data were available up to year 5 for 784 patients.
At one year, LDN was associated with an increase in mean serum creatinine level from 83 to 112 umol/L, Dr. Patel reported at the 26th Annual Congress of the European Association of Urology. This translated into a reduction in mean glomerular filtration rate (GFR) from 100 to 59 mL/min/1.73 m2. At one year, 53% of patients could be classified as having CKD stage 3-4. Mean GFR, however, did not change significantly between year 1 and year 5, said Dr. Patel, who presented study findings.
“The fall in GFR [following LDN] has been underestimated to date,” said Dr. Pitel, who noted that individuals wishing to donate a kidney will need to be informed of the latest data on renal function decline following LDN.
In patients with five years of follow-up, non-fatal cardiac events and cardiac mortality were reported in 0.4% and 0.05% of patients. New-onset hypertension was diagnosed in 10% of subjects.