Analysis looks at long-term risks of living kidney donation

Living kidney donors are not at increased risk for some health outcomes previously of concern, but do seem at risk for worse blood pressure and kidney function than nondonors. In addition, female donors seem to be at increased risk for preeclampsia. The findings of a systematic review and meta-analysis are published in Annals of Internal Medicine.

A team lead by researchers from the University of Cambridge, England, reviewed 52 published studies comprising more than 100,000 living kidney donors and more than 110,000 nondonors to assess the mid- and long-term health risks associated with living kidney donation in adults.

The data showed that kidney donors had higher diastolic blood pressure, poorer renal function, and higher risk for ESRD than nondonors. Female donors had an almost two-fold higher risk than nondonors for pregnancy-related complications, such as preeclampsia.

There was no evidence that living kidney donors had higher risk for mortality, cardiovascular disease, or type 2 diabetes, or reduced quality of life. Lead author, Emanuele Di Angelantonio, MD, Director of the NIHR Blood and Transplant Unit (BTRU) in Donor Health and Genomics suggested that the findings may be used to inform prospective donors of the risks associated with kidney donation.

The authors of an editorial from the University of Pennsylvania write that despite 6 decades of living kidney donation, large and high-quality studies of ESRD and other relevant outcomes after donation have been completed only in the past decade. While the systematic review and meta-analysis provide some important answers, the field is still a long way from offering precise risk estimates to prospective donors.

The study was funded by the NIHR Blood and Transplant Research Unit with the NIHR Cambridge Biomedical Research Centre funding part of the study.