Cargando…

Long-term prognosis after kidney donation: a propensity score matched comparison of living donors and non-donors from two population cohorts

BACKGROUND: Live donor nephrectomy is a safe procedure. However, long-term donor prognosis is debated, necessitating high-quality studies. METHODS: A follow-up study of 761 living kidney donors was conducted, who visited the outpatient clinic and were propensity score matched and compared to 1522 no...

Descripción completa

Detalles Bibliográficos
Autores principales: Janki, Shiromani, Dehghan, Abbas, van de Wetering, Jacqueline, Steyerberg, Ewout W., Klop, Karel W. J., Kimenai, Hendrikus J. A. N., Rizopoulos, Dimitris, Hoorn, Ewout J., Stracke, Sylvia, Weimar, Willem, Völzke, Henry, Hofman, Albert, Ijzermans, Jan N. M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Netherlands 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387377/
https://www.ncbi.nlm.nih.gov/pubmed/32440788
http://dx.doi.org/10.1007/s10654-020-00647-y
_version_ 1783564108449185792
author Janki, Shiromani
Dehghan, Abbas
van de Wetering, Jacqueline
Steyerberg, Ewout W.
Klop, Karel W. J.
Kimenai, Hendrikus J. A. N.
Rizopoulos, Dimitris
Hoorn, Ewout J.
Stracke, Sylvia
Weimar, Willem
Völzke, Henry
Hofman, Albert
Ijzermans, Jan N. M.
author_facet Janki, Shiromani
Dehghan, Abbas
van de Wetering, Jacqueline
Steyerberg, Ewout W.
Klop, Karel W. J.
Kimenai, Hendrikus J. A. N.
Rizopoulos, Dimitris
Hoorn, Ewout J.
Stracke, Sylvia
Weimar, Willem
Völzke, Henry
Hofman, Albert
Ijzermans, Jan N. M.
author_sort Janki, Shiromani
collection PubMed
description BACKGROUND: Live donor nephrectomy is a safe procedure. However, long-term donor prognosis is debated, necessitating high-quality studies. METHODS: A follow-up study of 761 living kidney donors was conducted, who visited the outpatient clinic and were propensity score matched and compared to 1522 non-donors from population-based cohort studies. Primary outcome was kidney function. Secondary outcomes were BMI (kg/m(2)), incidences of hypertension, diabetes, cardiovascular events, cardiovascular and overall mortality, and quality of life. RESULTS: Median follow-up after donation was 8.0 years. Donors had an increase in serum creatinine of 26 μmol/l (95% CI 24–28), a decrease in eGFR of 27 ml/min/1.73 m(2) (95% CI − 29 to − 26), and an eGFR decline of 32% (95% CI 30–33) as compared to non-donors. There was no difference in outcomes between the groups for ESRD, microalbuminuria, BMI, incidence of diabetes or cardiovascular events, and mortality. A lower risk of new-onset hypertension (OR 0.45, 95% CI 0.33–0.62) was found among donors. The EQ-5D health-related scores were higher among donors, whereas the SF-12 physical and mental component scores were lower. CONCLUSION: Loss of kidney mass after live donation does not translate into negative long-term outcomes in terms of morbidity and mortality compared to non-donors. TRIAL REGISTRATION: Dutch Trial Register NTR3795. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s10654-020-00647-y) contains supplementary material, which is available to authorized users.
format Online
Article
Text
id pubmed-7387377
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Springer Netherlands
record_format MEDLINE/PubMed
spelling pubmed-73873772020-08-11 Long-term prognosis after kidney donation: a propensity score matched comparison of living donors and non-donors from two population cohorts Janki, Shiromani Dehghan, Abbas van de Wetering, Jacqueline Steyerberg, Ewout W. Klop, Karel W. J. Kimenai, Hendrikus J. A. N. Rizopoulos, Dimitris Hoorn, Ewout J. Stracke, Sylvia Weimar, Willem Völzke, Henry Hofman, Albert Ijzermans, Jan N. M. Eur J Epidemiol Renal Epidemiology BACKGROUND: Live donor nephrectomy is a safe procedure. However, long-term donor prognosis is debated, necessitating high-quality studies. METHODS: A follow-up study of 761 living kidney donors was conducted, who visited the outpatient clinic and were propensity score matched and compared to 1522 non-donors from population-based cohort studies. Primary outcome was kidney function. Secondary outcomes were BMI (kg/m(2)), incidences of hypertension, diabetes, cardiovascular events, cardiovascular and overall mortality, and quality of life. RESULTS: Median follow-up after donation was 8.0 years. Donors had an increase in serum creatinine of 26 μmol/l (95% CI 24–28), a decrease in eGFR of 27 ml/min/1.73 m(2) (95% CI − 29 to − 26), and an eGFR decline of 32% (95% CI 30–33) as compared to non-donors. There was no difference in outcomes between the groups for ESRD, microalbuminuria, BMI, incidence of diabetes or cardiovascular events, and mortality. A lower risk of new-onset hypertension (OR 0.45, 95% CI 0.33–0.62) was found among donors. The EQ-5D health-related scores were higher among donors, whereas the SF-12 physical and mental component scores were lower. CONCLUSION: Loss of kidney mass after live donation does not translate into negative long-term outcomes in terms of morbidity and mortality compared to non-donors. TRIAL REGISTRATION: Dutch Trial Register NTR3795. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s10654-020-00647-y) contains supplementary material, which is available to authorized users. Springer Netherlands 2020-05-21 2020 /pmc/articles/PMC7387377/ /pubmed/32440788 http://dx.doi.org/10.1007/s10654-020-00647-y Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Renal Epidemiology
Janki, Shiromani
Dehghan, Abbas
van de Wetering, Jacqueline
Steyerberg, Ewout W.
Klop, Karel W. J.
Kimenai, Hendrikus J. A. N.
Rizopoulos, Dimitris
Hoorn, Ewout J.
Stracke, Sylvia
Weimar, Willem
Völzke, Henry
Hofman, Albert
Ijzermans, Jan N. M.
Long-term prognosis after kidney donation: a propensity score matched comparison of living donors and non-donors from two population cohorts
title Long-term prognosis after kidney donation: a propensity score matched comparison of living donors and non-donors from two population cohorts
title_full Long-term prognosis after kidney donation: a propensity score matched comparison of living donors and non-donors from two population cohorts
title_fullStr Long-term prognosis after kidney donation: a propensity score matched comparison of living donors and non-donors from two population cohorts
title_full_unstemmed Long-term prognosis after kidney donation: a propensity score matched comparison of living donors and non-donors from two population cohorts
title_short Long-term prognosis after kidney donation: a propensity score matched comparison of living donors and non-donors from two population cohorts
title_sort long-term prognosis after kidney donation: a propensity score matched comparison of living donors and non-donors from two population cohorts
topic Renal Epidemiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387377/
https://www.ncbi.nlm.nih.gov/pubmed/32440788
http://dx.doi.org/10.1007/s10654-020-00647-y
work_keys_str_mv AT jankishiromani longtermprognosisafterkidneydonationapropensityscorematchedcomparisonoflivingdonorsandnondonorsfromtwopopulationcohorts
AT dehghanabbas longtermprognosisafterkidneydonationapropensityscorematchedcomparisonoflivingdonorsandnondonorsfromtwopopulationcohorts
AT vandeweteringjacqueline longtermprognosisafterkidneydonationapropensityscorematchedcomparisonoflivingdonorsandnondonorsfromtwopopulationcohorts
AT steyerbergewoutw longtermprognosisafterkidneydonationapropensityscorematchedcomparisonoflivingdonorsandnondonorsfromtwopopulationcohorts
AT klopkarelwj longtermprognosisafterkidneydonationapropensityscorematchedcomparisonoflivingdonorsandnondonorsfromtwopopulationcohorts
AT kimenaihendrikusjan longtermprognosisafterkidneydonationapropensityscorematchedcomparisonoflivingdonorsandnondonorsfromtwopopulationcohorts
AT rizopoulosdimitris longtermprognosisafterkidneydonationapropensityscorematchedcomparisonoflivingdonorsandnondonorsfromtwopopulationcohorts
AT hoornewoutj longtermprognosisafterkidneydonationapropensityscorematchedcomparisonoflivingdonorsandnondonorsfromtwopopulationcohorts
AT strackesylvia longtermprognosisafterkidneydonationapropensityscorematchedcomparisonoflivingdonorsandnondonorsfromtwopopulationcohorts
AT weimarwillem longtermprognosisafterkidneydonationapropensityscorematchedcomparisonoflivingdonorsandnondonorsfromtwopopulationcohorts
AT volzkehenry longtermprognosisafterkidneydonationapropensityscorematchedcomparisonoflivingdonorsandnondonorsfromtwopopulationcohorts
AT hofmanalbert longtermprognosisafterkidneydonationapropensityscorematchedcomparisonoflivingdonorsandnondonorsfromtwopopulationcohorts
AT ijzermansjannm longtermprognosisafterkidneydonationapropensityscorematchedcomparisonoflivingdonorsandnondonorsfromtwopopulationcohorts