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Kidney Week

Abstract: TH-PO972

Long-Term Renal and Non-Renal Morbidities in Living Kidney Donor

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

  • Kim, Yaerim, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Ryu, Hyunjin, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Jung, Young Lee, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Choi, Jae shin, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Hwang, Cheolgu, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Yu, Mi-yeon, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Kim, Yon Su, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Lee, Hajeong, Seoul National University Hospital, Seoul, Korea (the Republic of)
Background

Kidney transplantation (KT) is the best treatment option for end-stage renal disease (ESRD). Safety of kidney donor has become an overarching theme according to increase of KT from living donor. However, risk factors for renal and non-renal morbidities were not clearly identified.

Methods

We observed 1,238 living kidney donors who underwent nephrectomy from January 1986 to February 2016 in a single tertiary hospital retrospectively. We estimated overall incidences of renal morbidities including ESRD and non-renal morbidities: hypertension (HTN), prediabetes, diabetes and malignancy. In addition, we analyzed significant risk factors for renal and non-renal morbidities.

Results

A total of 901 donors who were followed up more than 1 month were finally included. Median age was 42 (IQR, 18-65) years and 47.2% was women. Preexisting HTN was found in 47 (5.2%) donors. Only three donors had impaired glucose tolerance or diabetes at the time of donation. After 27 months of follow-up, final estimated glomerular filtration rate (eGFR) was 71.3 ± 14.36 ml/min/1.73m2. One donor progressed to ESRD. Total 20.3% of donors failed to recover up to eGFR ≥ 60 ml/min/1.73m2. Seventy eight (8.7%) of 901 donors presented new onset HTN, 43 (4.8%) prediabetes or diabetes, and 17 (1.9%) malignancy after donation. Interestingly, donors with preexisting HTN or diabetes did not show increased inadequate renal recovery. In the multivariate analysis, women, higher BMI and lower initial eGFR contributed to new onset hypertension independently. In addition, older age, higher BMI and inadequate renal recovery elevated new onset diabetes. Malignancy after donation was affected by older age, lower serum uric acid and albumin levels. Finally, inadequate renal recovery was associated with older age, higher BMI and lower initial eGFR.

Conclusion

Post-donation renal and non-renal morbidities are not rare. In our study, donors with older age, higher BMI and lower initial GFR should be monitored meticulously for developing renal and non-renal complications after donation. It is important to control adjustable risk factors strictly such as BMI and uric acid before and after donation to maintain their residual kidney function well.