Comparison of Medium-term Outcomes of Living Kidney Donors With Longitudinal Healthy Control in the U.K.
BACKGROUND: Understanding the outcomes and risks for live kidney donors is increasingly important; this study investigated all-cause mortality and morbidity outcomes of live kidney donors compared with healthy cohort.
METHODS: Live donor dataset was obtained from UK Transplant Registry and a comparator nondonor cohort selected from The Health Improvement Network (THIN) database, a UK primary healthcare database. All live kidney donors (LD) from 1 January 2001 to 31 December, 2013 were included, with follow-up until 31 December 2016.
RESULTS: There were 9750 LD and 19 071 THIN participants. Median follow up (IQR) for LD was 8.4 (6.0 to 11.3) years & THIN 5.4 (2.6 to 8.5) years. In up to 15 years follow-up end stage renal disease (ESRD) was observed in 1 LD versus 7 THIN (P=0.280). Nine LD had eGFR<30ml/min/1.73m versus 43 in THIN (P=0.012), but no statistically significant difference in adjusted logistic regression analyses. Risk of diabetes, depression and cardiovascular disease was significantly higher for THIN cohort in adjusted analyses. The risk of hypertension was higher for LD at 5 years, but was not significantly different in fully adjusted analyses at 10 years. There were 68 deaths in LD and 485 in THIN over the follow-up period, with significant difference in mortality favoring LD (P<0.001).
CONCLUSIONS: The medium-term morbidity and mortality outcomes of live donors in comparison with a healthy cohort suggest that live donation is not associated with excess mortality, ESRD or morbidity, in at least 10 years follow-up.
|投稿者||Krishnan, Nithya; Mumford, Lisa; Lipkin, Graham; Gill, Paramjit; Fletcher, Simon; Dasgupta, Indranil; Ryan, Ronan; Raymond, Neil T|