Long-term outcomes of living kidney donors: a single centre experience of 29 years

Abstract

Aim: Living kidney donation provides the best source of kidney graft. The mortality and morbidity rates are small but the long-term effects have not been studied. This is a report on our 29-year experience of living kidney donation.

Methods: All living donors were arranged to have follow-ups. Defaulters were traced via a territory-wide computer system.

Results: A total of 149 living kidney donor operations were performed. 136/149 records were available. 41 defaulted follow-up. One donor died of multiple myeloma. The male to female ratio was 1.00 to 1.52. Mean age at donation was 33.94±9.66 years. Mean follow-up duration was 160.39±87.96 months. Hypertension was diagnosed in 27 donors (19.9%). 22 donors (17.3%) had stage 3 chronic kidney disease (CKD). Glomerular filtration rate (GFR) dropped from 90.95±15.62 mL/min per 1.73 m2 at time 0 to 66.29±12.06 mL/min per 1.73 m2 at 2 years. GFR improved subsequently and remained stable for 25 years. Age at donation was associated with hypertension (HT) in univariate and multivariate analyses. HT was not associated with sex or GFRs over time. Using binary logistic regression, age at donation was associated with the development of stage 3 CKD and GFR before donation was associated with lower CKD risk. In multivariate analysis, only age at donation was associated with CKD. Other co-morbidities included: hyperlipidaemia 16/136, diabetes mellitus 6/136, cardiovascular event 1/136, stroke 1/136 and cancer 5/136.

Conclusions: Living kidney donors had reductions in GFR post uninephrectomy with subsequent improvement. A significant proportion developed HT and stage 3 CKD. Age at donation was a strong determinant of development of HT and stage 3 CKD.