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Abstract: SA-PO822

Risk Factors for Developing Low eGFR and Albuminuria in Living Kidney Donors

Session Information

Category: Transplantation

  • 2002 Transplantation: Clinical

Authors

  • Dhalla, Anisha, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
  • Al-Wahsh, Huda, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
  • Lam, Ngan, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
Background

Chronic kidney disease is associated with significant morbidity and mortality in the general population, but little is known about the incidence and risk factors associated with developing kidney dysfunction in living donors following nephrectomy.

Methods

We conducted a retrospective, population-based control study using linked healthcare databases in Alberta, Canada to identify 590 donors who underwent nephrectomy between May 2001 and December 2017. The primary outcome was evidence of sustained kidney dysfunction following nephrectomy, defined as either 2 estimated glomerular filtration rate (eGFR) measurements <45 mL/min/1.73 m2 or 2 measurements of moderate or severe albuminuria that were at least 90 days apart. We used Cox proportional hazard regression analyses to examine the association between potential risk factors and the outcome of post-donation kidney dysfunction.

Results

Over a median follow-up period of 8.6 years (interquartile range [IQR]: 4.7-16.9 years), 47 donors (8.0%) developed sustained kidney dysfunction, with an incidence rate of 9.2 per 1,000 person-years (95% confidence interval: 6.6-11.8). The median time for development of kidney dysfunction beyond the first year after nephrectomy was 2.9 years (IQR: 1.4-8.0 years). Donors who developed kidney dysfunction after donation were more likely to be older, male, have lower pre-donation eGFR, have evidence of pre- or post-donation hypertension, and post-donation diabetes.

Conclusion

A small proportion of kidney donors will develop post-donation kidney dysfunction. Donors with risk factors associated with sustained kidney dysfunction may benefit from more diligent follow-up care.

Kaplan-Meier curve with 95% confidence interval of estimated kidney dysfunction free survival in living kidney donors from one-year post-donation onwards.

Funding

  • Government Support – Non-U.S.