Reductions in kidney function associated with nephrectomy in living kidney donors, in the absence of renal disease or comorbidity, does not result in adverse changes in cardiovascular structure and function at 5 years, investigators reported at the European Renal Association-European Dialysis and Transplant Association 2020 virtual congress.
The finding is from a longitudinal study comparing 50 living kidney donors and 45 healthy controls with a mean follow-up time of 5.7 years. The mean estimated glomerular filtration rate (eGFR) among the donors was 95 mL/min/1.73 m2 prior to nephrectomy and 65, and 67 mL/min/1.73 m2 at 1 and 5 years, respectively, Anna Price, a PhD candidate at the University of Birmingham and Queen Elizabeth Hospital in Birmingham, UK, and colleagues reported. By comparison, among the control, the eGFR declined by 1 mL/min/1.73 m2 per year. At 5 years, left ventricular (LV) mass in the donors and controls were similar (113 vs 115 g), as were LV volume and LV geometry.
“This study offers reassurance to living kidney donors and the transplant community but should prompt further work into the causes of cardiovascular disease in [chronic kidney disease] as we have found no medium term deleterious cardiovascular effects of an isolated reduction in eGFR,” the investigators concluded.
In addition, results showed that markers of vascular stiffness (pulse wave velocity and augmentation index) were increased in donors compared with controls at 12 months, but did not differ significantly at 5 years. The investigators did not observe any changes in office or ambulatory blood pressure at any time point in either group.
At 5 years, the uric acid level was significantly higher in donors than controls (335 vs. 276 µmol/L) and had increased after the 12 month time point despite an improvement in eGFR, according to the investigators.
Price A, Moody W, Stoll V. Cardiovascular effects of unilateral nephrectomy in living kidne donor at 5 years. Presented at the European Renal Association-European Dialysis and Transplant Association 2020 virtual congress held June 6-9 Abstract MO018. https://www.era-edta.org/en/virtual-meeting/#!resources/cardiovascular-effects-of-unilateral-nephrectomy-in-living-kidney-donors-at-five-years