Proteinuria and reduced kidney function in living kidney donors: A systematic review, meta-analysis, and meta-regression

Amit X. Garg, Norman Muirhead, Greg Knoll, Robert C. Yang, G. V.R. Prasad, H. Thiessen-Philbrook, M. P. Rosas-Arellano, A. Housawi, Neil Boudville

Research output: Contribution to journalArticlepeer-review

Abstract

We reviewed any study where 10 or more healthy adults donated a kidney, and proteinuria, or glomerular filtration rate (GFR) was assessed at least 1 year later. Bibliographic databases were searched until November 2005. 31 primary authors provided additional information. Forty-eight studies from 27 countries followed a total of 5048 donors. An average of 7 years after donation (range 1-25 years), the average 24 h urine protein was 154 mg/day and the average GFR was 86 ml/min. In eight studies which reported GFR in categories, 12% of donors developed a GFR between 30 and 59 ml/min (range 0-28%), and 0.2% a GFR less than 30 ml/min (range 0-2.2%). In controlled studies urinary protein was higher in donors and became more pronounced with time (three studies totaling 59 controls and 129 donors; controls 83 mg/day, donors 147 mg/day, weighted mean difference 66 mg/day, 95% confidence interval (CI) 24-108). An initial decrement in GFR after donation was not accompanied by accelerated losses over that anticipated with normal aging (six studies totaling 189 controls and 239 donors; controls 96 ml/min, donors 84 ml/min, weighted mean difference 10 ml/min, 95% CI 6-15; difference not associated with time after donation (P=0.2)). Kidney donation results in small increases in urinary protein. An initial decrement in GFR is not followed by accelerated losses over a subsequent 15 years. Future studies will provide better estimates, and identify those donors at least risk of long-term morbidity.

Original languageEnglish (US)
Pages (from-to)1801-1810
Number of pages10
JournalKidney international
Volume70
Issue number10
DOIs
StatePublished - Nov 27 2006
Externally publishedYes

Keywords

  • Follow-up studies
  • Glomerular filtration rate
  • Kidney transplantation
  • Living donors
  • Meta-analysis
  • Proteinuria

ASJC Scopus subject areas

  • Nephrology

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