A prospective controlled study of kidney donors: Baseline and 6-month follow-up

Bertram L. Kasiske, Teresa Anderson-Haag, Hassan N. Ibrahim, Todd E. Pesavento, Matthew R. Weir, Joseph M. Nogueira, Fernando G. Cosio, Edward S. Kraus, Hamid H. Rabb, Roberto S. Kalil, Andrew A. Posselt, Paul L. Kimmel, Michael W. Steffes

Research output: Contribution to journalArticle

Abstract

Background: Most previous studies of living kidney donors have been retrospective and have lacked suitable healthy controls. Needed are prospective controlled studies to better understand the effects of a mild reduction in kidney function from kidney donation in otherwise healthy individuals. Study Design: Prospective, controlled, observational cohort study. Setting & Participants: Consecutive patients approved for donation at 8 transplant centers in the United States were asked to participate. For every donor enrolled, an equally healthy control with 2 kidneys who theoretically would have been suitable to donate a kidney also was enrolled. Predictor: Kidney donation. Measurements: At baseline predonation and at 6 months after donation, medical history, vital signs, measured (iohexol) glomerular filtration rate, and other measurements were collected. There were 201 donors and 198 controls who completed both baseline and 6-month visits and form the basis of this report. Results: Compared with controls, donors had 28% lower glomerular filtration rates at 6 months (94.6 ± 15.1 [SD] vs 67.6 ± 10.1 mL/min/1.73 m2; P < 0.001), associated with 23% greater parathyroid hormone (42.8 ± 15.6 vs 52.7 ± 20.9 pg/mL; P < 0.001), 5.4% lower serum phosphate (3.5 ± 0.5 vs 3.3 ± 0.5 mg/dL; P < 0.001), 3.7% lower hemoglobin (13.6 ± 1.4 vs 13.1 ± 1.2 g/dL; P < 0.001), 8.2% greater uric acid (4.9 ± 1.2 vs 5.3 ± 1.1 mg/dL; P < 0.001), 24% greater homocysteine (1.2 ± 0.3 vs 1.5 ± 0.4 mg/L; P < 0.001), and 1.5% lower high-density lipoprotein cholesterol (54.9 ± 16.4 vs 54.1 ± 13.9 mg/dL; P = 0.03) levels. There were no differences in albumin-creatinine ratios (5.0 [IQR, 4.0-6.6] vs 5.0 [IQR, 3.3-5.4] mg/g; P = 0.5), office blood pressures, or glucose homeostasis. Limitations: Short duration of follow-up and possible bias resulting from an inability to screen controls with kidney and vascular imaging performed in donors. Conclusions: Kidney donors have some, but not all, abnormalities typically associated with mild chronic kidney disease 6 months after donation. Additional follow-up is warranted.

Original languageEnglish (US)
Pages (from-to)577-586
Number of pages10
JournalAmerican Journal of Kidney Diseases
Volume62
Issue number3
DOIs
StatePublished - Sep 1 2013

Keywords

  • Chronic kidney disease
  • glomerular filtration rate
  • mineral and bone disorders
  • patient safety
  • unilateral nephrectomy

ASJC Scopus subject areas

  • Nephrology

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    Kasiske, B. L., Anderson-Haag, T., Ibrahim, H. N., Pesavento, T. E., Weir, M. R., Nogueira, J. M., Cosio, F. G., Kraus, E. S., Rabb, H. H., Kalil, R. S., Posselt, A. A., Kimmel, P. L., & Steffes, M. W. (2013). A prospective controlled study of kidney donors: Baseline and 6-month follow-up. American Journal of Kidney Diseases, 62(3), 577-586. https://doi.org/10.1053/j.ajkd.2013.01.027