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.