Long-Term Complications of Living Kidney Donation

Ying-Chuan Liao ； Ming-Ju Wu ； Cheng-Hsu Chen ； Chi-Hung Cheng ； Hao-Chung Ho ； Chi-Rei Yang ； Kuo-Hsiung Shu

《Acta Nephrologica》 21卷2期 (2007/06) Pp. 112-117

並列摘要

Background: Some studies show that individuals with decreased renal mass may suffer from higher risk in developing proteinuria, hypertension and chronic renal failure in the long run.
Materials and methods: We conducted a cross-sectional, observational study to evaluate living kidney donors of our hospital over the past 22 years. Data from medical charts were retrieved at donation and last follow-up.
Results: There were 10 male and 21 female donors. The mean age at donation was 45.3±13.5 years old. The serum creatinine at donation was 0.86±0.21 mg/dl while the serum creatinine at follow-up was 1.32±0.66 mg/dl. (P=0.008). The mean duration of follow-up was 8.03±6.3 years. The mean age at follow-up was 54.7±17.5 years old. At last follow-up, 6 patients (19.35%) have hypertension. Four patients (12.9%) have proteinuria. Two patients (6.45%) have estimated glomerular filtration rate (eGFR) less than 30 ml/min. The mean eGFR at follow-up was 56.8±17.5 ml/min. The occurrence of hypertension, proteinuria and chronic renal failure of these donors were not related to their gender, creatinine level at donation and age at donation except the association between hypertension and age at donation (P=0.017). Hypertensive donor was older (74.8 vs. 49.9 years, P=0.001) and with longer duration of follow-up (16.8 vs. 5.9 years, P=0.001). On the other hand, donor with proteinuria were also of older age (73.3 vs. 52.0 years, P=0.017) and with longer duration of follow-up (17.0 vs. 6.7 years, P=0.007). Linear regression analysis revealed that both increasing age and longer duration post surgery were associated with a lower eGFR (R^2=0.162, P=0.025 for age; R^2=0.2688, P=0.003 for duration). The multiple regression model showed a borderline statistical significance in the duration post surgery as a predictor of decreased eGFR (P=0.053) while the age at follow-up was not (P=0.96). Both hypertension and proteinuria were related to decreased eGFR (P=0.024 and P=0.039, respectively). Donors with more risk factors (either hypertension or proteinuria) were associated with a lower eGFR (P=0.016).
Conclusion: A significant proportion of living donors may develop proteinuria and/or hypertension in the long run, which was related to either aging or increasing duration after kidney donation.

並列關鍵字

chronic renal failure ； hypertension ； kidney transplantation ； living donor ； proteinuria