Acute dialysis risk in living kidney donors
Lam N, Huang A, Feldman LS, Gill JS, Karpinski M, Kim J, Klarenbach SW, Knoll GA, Lentine KL, Nguan CY, Parikh CR, Prasad GR, Treleaven DJ, Young A, Garg AX; Donor Nephrectomy Outcomes Research (DONOR) Network. Nephrol Dial Transplant. 2012; 27(8):3291-5. Epub 2012 Jan 30.
Background — Reduced kidney function confers a higher risk of acute kidney injury at the time of an inciting event, such as sepsis. Whether the same is true in those with reduced renal mass from living kidney donation is unknown.
Methods — The researchers conducted a population-based matched cohort study of all living kidney donors in the province of Ontario, Canada who underwent donor nephrectomy from 1992 to 2009. The researchers manually reviewed the medical records of these living kidney donors and linked this information to provincial health care databases. Non-donors were selected from the healthiest segment of the general population.
Results — There were 2027 donors and 20 270 matched non-donors. The median age was 43 years (interquartile range 34–50) and individuals were followed for a median of 6.6 years (maximum 17.7 years). The primary outcome was acute dialysis during any hospital stay. Reasons for hospitalization included infectious diseases, cardiovascular diseases and hematological malignancies. Only one donor received acute dialysis in follow-up (6.5 events per 100 000 person-years), a rate which was statistically no different than 14 non-donors (9.4 events per 100 000 person-years).
Conclusions — These results are reassuring for the practice of living kidney donation. Longer follow-up of this and other donor cohorts will provide more precise estimates about this risk.
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Kidney and urinary tract disorders