Living kidney donors who experience acute kidney injury (AKI) have a higher likelihood of progressing to end-stage kidney disease (ESKD) and dying than donors without AKI, investigators reported at the American Society of Nephrology’s Kidney Week 2022 in Orlando, Florida. Their study identified risk factors that predispose kidney donors to AKI.

Among 42,955 adult kidney donors, AKI developed in 3055 within the first year of transplantation. At the time of donation, patients with vs without AKI were significantly older (44.2 vs 40.8 years), male, nicotine-dependent, and obese (body mass index greater than 30 kg/m2), Nasrollah Ghahramani, MD, MS, of Pennsylvania State University College of Medicine in Hershey, reported on behalf of his team. The AKI group also was significantly more likely to have hypertension and take a diuretic agent.

Within 5 years of donation, ESKD occurred in 5554 donors, including 1874 donors with AKI history. Death occurred in 1266 donors, including 501 donors with AKI history. After propensity score matching, AKI was significantly associated with 15.2-fold increased odds of ESKD and 9.9-fold increased odds of mortality, Dr Ghahramani reported.

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“Potential donors and clinicians should be aware of these risk factors for acute kidney injury following kidney donation,” Dr Ghahramani told Renal & Urology News. “These factors are not universal contraindications to donation. However, donors with these risk factors should be monitored closely for possible development of acute kidney injury and should receive timely interventions.”


Akkari ARM, Hafid M, Abdulbasit M, Salameh OKM, Ghahramani N. Kidney donors with and without post-donation AKI: Comparison of baseline characteristics and long-term outcomes. Presented at: Kidney Week 2022; November 3-6, Orlando, Florida. Abstract FR-PO111.