Kidney Week

Abstract: FR-PO1134

Age-Stratified Outcomes in Living Kidney Donors

Session Information

• Transplantation: Clinical - Transplant Access, Recipient Evaluation, Living Donors, Pregnancy, and More
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2002 Transplantation: Clinical

Authors

• Mahbub, Hasan Mohammad, Detroit Medical Center, Detroit, Michigan, United States

Hasan Mohammad Mahbub, MD

• Ray, Madhab, Henry Ford Hospital, Detroit, Michigan, United States

Madhab Ray, MD, MS, MBA

• Oki, Rikako, Henry Ford Hospital, Detroit, Michigan, United States

Rikako Oki, MD, PhD

• Almokdad, Mohammad, Henry Ford Hospital, Detroit, Michigan, United States

Mohammad Almokdad, MD

• Callaghan, Matthew, Henry Ford Hospital, Detroit, Michigan, United States

Matthew Callaghan, MS

• Boby, Niya, Henry Ford Hospital, Detroit, Michigan, United States

Niya Boby

• Ravi, Akshaya, Henry Ford Hospital, Detroit, Michigan, United States

Akshaya Ravi

• Ashish, Abhigail, Henry Ford Hospital, Detroit, Michigan, United States

Abhigail Ashish

• Ansari, Rehan, Henry Ford Hospital, Detroit, Michigan, United States

Rehan Ansari, MD

• Shrivastava, Pritika, Henry Ford Hospital, Detroit, Michigan, United States

Pritika Shrivastava, MD

Background

Living kidney donations in older adults remains an area of evolving clinical scrutiny regarding cardiometabolic comorbidities and post-donation renal trajectories. This retrospective single-center study evaluated longitudinal renal function outcomes, including creatinine (Cr) slope and eGFR decline, in living donors stratified by age at donation (< 65 vs. ≥ 65 years).

Methods

Over a 5-year period (2020–2025) 180 subjects were analyzed: 171 in the younger cohort and 9 in the older cohort. Comorbidity burden, Basal Metabolic Index (BMI), and serial serum cr were collected at baseline, at 2 weeks, 6 months, and 1-year post-nephrectomy. A linear creatinine slope (mg/dL/week) was modeled per individual, with group comparisons via independent-samples t-tests (significance: p < 0.05).

Results

The younger cohort averaged 42.4 ± 10.7 years and the older cohort 69.0 ± 2.4 years; 65% were female in both cohorts. Older donors had higher rates of hypertension (11.1% vs 2.4%) and hyperlipidemia (33.3% vs 13.0%), though differences were not statistically significant. BMI, diabetes, hyperuricemia, and metabolic syndrome were similar between groups. Pre-donation creatinine was comparable (0.82 vs 0.83 mg/dL, p=0.833), but older donors had lower baseline eGFR (83.4 vs 100.6 mL/min/1.73 m², p=0.001). Two-week post-nephrectomy creatinine was similar (1.27 vs 1.26 mg/dL, p=0.955), but became higher in older donors at 6 months (1.35 vs 1.18 mg/dL, p=0.046), with a similar trend at 1 year (1.34 vs 1.17 mg/dL, p=0.076). One-year eGFR remained lower in older donors (49.3 vs 67.5 mL/min/1.73 m²), reflecting greater proportional decline (~41% vs ~33%). Creatinine slopes were similar between groups.

Conclusion

Donors aged 65 and older enter donation with lower renal reserve, a gap that persists and widens post-donation. These findings highlight the need for individualized pre-donation counseling and rigorous post-donation surveillance in this population. Larger prospective studies are needed to establish longer trends for older living donors.