A prospective controlled study of metabolic and physiologic effects of kidney donation suggests that donors retain stable kidney function over the first nine years

Bertram L. Kasiske, Tracy L. Anderson-Haag, Daniel A. Duprez, Roberto S. Kalil, Paul L. Kimmel, Todd E. Pesavento, Jon J. Snyder, Matthew R. Weir

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

While there have been numerous studies of living kidney donors, most have been retrospective without suitable controls and have yielded conflicting results. To clarify this we studied 205 living donor candidates and 203 controls having no medical conditions precluding donation. Before and at six months, one, two, three, six, and nine years after donation we measured iohexol glomerular filtration rate, clinic blood pressure, urine protein excretion and metabolic parameters reported to be affected by kidney function. We measured 24 hour ambulatory blood pressure at three, six, and nine years and at six and nine years blood pressure after treadmill exercise, carotid-femoral pulse wave velocity and arterial elasticity. Between six months and nine years, the mean (95% confidence interval) change in glomerular filtration rate was significantly different among 133 donors 0·02 (-0·16−0·20) mL/min/1·73m2/year versus -1·26 (-1·52−-1·00) mL/min/1·73m2/year in 113 healthy controls. Blood pressure, urine protein, urine albumin, glucose, hemoglobin A1c, insulin, and lipoproteins were not different in controls versus donors; but parathyroid hormone, homocysteine and uric acid remained higher at nine years. At six and nine years carotid-femoral pulse wave velocity was not different, but the mean small artery elasticity was significantly lower in 141 donors 6·1 mL/mmHg x100, versus 113 controls 7·1 mL/mmHg x100, and 6·1 mL/mmHg x100 in 137 donors versus 7·6 mL/mmHg x100 in 112 controls at six and nine years, respectively [significant adjusted difference of 1·1 mL/mmHg x100]. Thus, donors remain healthy with stable kidney function for the first nine years, but differences in metabolic and vascular parameters could be harbingers of adverse outcomes requiring future interventions.

Original languageEnglish (US)
Pages (from-to)168-175
Number of pages8
JournalKidney international
Volume98
Issue number1
DOIs
StatePublished - Jul 2020

Bibliographical note

Funding Information:
This study was funded by the National Institutes of Health ( NIH ) under cooperative agreement U01 DK066013. This study was also supported by the Hennepin Healthcare Research Institute, Minneapolis, MN, which did not participate in any aspect of the study. The authors thank Lisa Berndt, Valerie Ferment, Lalitha Anandagoda, Denyse Breault, and Janice Lovick for their help in conducting this study.

Funding Information:
This study was funded by the National Institutes of Health (NIH) under cooperative agreement U01 DK066013. This study was also supported by the Hennepin Healthcare Research Institute, Minneapolis, MN, which did not participate in any aspect of the study. The authors thank Lisa Berndt, Valerie Ferment, Lalitha Anandagoda, Denyse Breault, and Janice Lovick for their help in conducting this study. Each of the authors met all 4 criteria for authorship designated by the International Committee of Medical Journal Editors (http://www.icmje.org/recommendations/browse/roles-and-responsibilities/defining-the-role-of-authors-and-contributors.html). All authors approved the final submitted version of the manuscript.

Publisher Copyright:
© 2020 International Society of Nephrology

Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.

Keywords

  • albuminuria
  • blood pressure
  • glomerular filtration rate
  • pulse wave velocity

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural

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