Living Kidney Donor Outcomes Vary by Race
Black and Hispanic living kidney donors are at increased relative risk for hypertension, diabetes requiring drug therapy, and CKD compared with their white counterparts, according to researchers.
Krista L. Lentine, MD, of Saint Louis University School of Medicine, and colleagues reviewed data from 4,650 individuals who had been living kidney donors from October 2987 through July 2007. The researchers linked identifiers from the Organ Procurement and Transplantation Network with administrative data of a private U.S. health insurer.
The investigators determined post-nephrectomy medical diagnoses and conditions requiring medical treatment from billing claims.
The study population was 76.3% white, 13.1% black, 8.2% Hispanic, and 2.4% other. The median time from donation to the end of insurance benefits was 7.7 years.
After donation, blacks had a 52% increased relative risk of hypertension and a more than twofold increased risk of diabetes requiring drug therapy and CKD compared with whites, after adjusting for multiple variables, Dr. Lentine's group reported in the New England Journal of Medicine (2010;363:724-732). Hispanics had a 36% increased relative risk of hypertension, a nearly threefold increased risk of diabetes requiring drug treatment, and a twofold increased risk of CKD.
The researchers noted that the prevalence of diabetes among all donors did not exceed that in the general population, but the prevalence of hypertension exceeded estimates from the National Health and Nutrition Examination Survey in some subgroups, such as Hispanics.
“Race and ethnic group should not be used to discourage donor evaluation, but these data may increase awareness of variation in long-term outcomes among living donors and of the need for longer in-depth follow-up of demographically diverse living donors,” the authors concluded.