Abstract: TH-PO891
Sex Disparity and Kidney Function in Living Kidney Donors
Session Information
- Transplantation: Donation and Access
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Tantisattamo, Ekamol, University of California Irvine School of Medicine, Irvine, California, United States
- Rochanaroon, Voramol, Rayong Hospital, Rayong, Thailand
- Noree, Wanprapit, Police General Hospital, Bangkok, Thailand
- Thiravetyan, Ben, Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
- Suenghataiphorn, Thanathip, Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
- Chuenchaem, Urairat, Bumrungrad International Hospital, Bangkok, Thailand
- Kulthamrongsri, Narathorn, Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
- Srikulmontri, Thitiphan, Siriraj Health Science Education Excellence Center, Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
- Puchongmart, Chanokporn, Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
- Naunsil, Piengpich, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Vutthikraivit, Possawat, Phramongkutklao College of Medicine, Mahidol University, Bangkok, Thailand
- Tanariyakul, Manasawee, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii, United States
- Leesutipornchai, Thiratest, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii, United States
- Kittrakulrat, Jathurong, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Kunupakan, Sasithorn, University of California Irvine School of Medicine, Irvine, United States
- Wattanachayakul, Phuuwadith, University of California Irvine School of Medicine, Irvine, United States
Background
While a sex disparity in chronic kidney disease exists, it remains unclear if there is a disproportionate difference in kidney function following kidney donation.
Methods
A retrospective cohort study using OPTN/SRTR includes adult living kidney donors (LKD) undergoing donation between June 1972 and September 2022. The time-to-event of >35% rise in post-donation serum creatinine (SCr) from pre-donation SCr between female and male LKD was investigated by multiple Cox proportional hazard regression.
Results
In a cohort of 136,814 living kidney donors, mean±SD age was 42±12 years and 61% were female. Out of 103,938 LKD with post-donation SCr data at 6, 12, or 24 months, 75,343 (72%) experienced the event within a median time to follow-up of 6.3 months (IQR 4.1, 8.7). The incidence rate of the event was 0.09 person-months. The mean and median pre-donation SCr was 0.85±0.19 and 0.80 mg/dL, respectively with notably female and male mean pre-donation SCr were 0.77±0.14 and 0.99±0.17 mg/dL, respectively (mean difference of 22%; (95%CI 0.22, 0.22; P <0.001). Compared to female LKD, male LKD had a 12% significantly higher risk of experiencing an increased post-donation SCr >35% (HR 1.12; 95%CI 1.10, 1.13; P <0.001). After adjusting for age, race/ethnicity, U.S. citizenship, education level, history of pre-donation hypertension, pre-donation BMI, SBP, DBP, post-donation proteinuria, and the interaction term between sex and pre-donation SCr (≤0.8 or >0.8), male LKD remained at a significantly higher risk for the event (HR 1.42; 95%CI 1.36, 1.47; P <0.001). Furthermore, pre-donation SCr was identified as an effect modifier with an increased risk of rising SCr >35% observed in male LKD with pre-donation SCr >0.8 mg/dL (Pinteraction <0.001).
Conclusion
Male LKD with pre-donation SCr >0.8 mg/dL are at a higher risk of experiencing an increased post-donation SCr >35% compared to female LKD regardless of other pre- and post-donation factors. Despite women contributing as LKD more than men, addressing the underlying causes of sex disparity may provide the opportunity to increase donations while taking precaution for high-risk population.