Details
| Original language | English |
|---|---|
| Pages (from-to) | 396-404 |
| Number of pages | 9 |
| Journal | Transplantation proceedings |
| Volume | 51 |
| Issue number | 2 |
| Early online date | 4 Jan 2019 |
| Publication status | Published - Mar 2019 |
| Externally published | Yes |
Abstract
Context: Living kidney donation is considered a safe procedure with excellent outcomes. The great demand for organs has changed the suitability criteria for donation and older or hypertensive donors are increasingly accepted. Methods: We reviewed the charts of 200 adults who donated a kidney at the University Hospital Hannover. Data regarding diastolic, systolic, mean blood pressure, renal function, and proteinuria at baseline and post-donation follow-up visits were recorded. A Mann-Whitney U test was performed to compare the post-nephrectomy development of blood pressure, estimated glomerular filtration rate (eGFR), and proteinuria between men and women, hypertensives and normotensives, and older (≥65 years) and younger (<65 years) donors. Multivariable time-dependent Cox regression models were used to evaluate eGFR decline post-donation, after adjustment for covariates. Results: The majority of donors were female (64.5%), and 29.0% had pre-existing hypertension. The mean age at donation was 49 years, and 9.5% were older than 65 years. During a median follow-up of 3 years, no significant differences in proteinuria and change in renal function were observed between both sexes or hypertensive and normotensive donors. In contrast, older donors exhibited a faster decline in renal function. Mean eGFR (chronic kidney disease epidemiology collaboration equation) pre-donation was 99.6 ± 21.9 mL/min in younger donors and 77.6 ± 17.7 mL/min in older donors (P <.001). The respective mean values at the last follow-up visit were 81.3 ± 24.0 and 46.8 ± 17.9 mL/min (P <.001). After adjustment for sex and preexisting hypertension, compared to younger donors, older donors had a 2.39 hazard ratio for eGFR decline. Conclusion: Older adults display a faster decline in renal function after donation and thus should be carefully evaluated for suitability before donation.
ASJC Scopus subject areas
- Medicine(all)
- Surgery
- Medicine(all)
- Transplantation
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In: Transplantation proceedings, Vol. 51, No. 2, 03.2019, p. 396-404.
Research output: Contribution to journal › Article › Research › peer review
}
TY - JOUR
T1 - Predictors of Outcomes of Living Kidney Donation
T2 - Impact of Sex, Age and Preexistent Hypertension
AU - Chatzikyrkou, C.
AU - Scurt, F. G.
AU - Clajus, C.
AU - Roumeliotis, S.
AU - Mertens, P. R.
AU - Haller, H.
AU - Blume, C.
AU - Liakopoulos, V.
N1 - Funding Information: Work performed by P.R. Mertens is supported by the Deutsche Forschungsgemeinschaft (DFG grants Me1365/7-2, Me1365/9-1) and Collaborative Research Centers (CRC), 854 project A01.
PY - 2019/3
Y1 - 2019/3
N2 - Context: Living kidney donation is considered a safe procedure with excellent outcomes. The great demand for organs has changed the suitability criteria for donation and older or hypertensive donors are increasingly accepted. Methods: We reviewed the charts of 200 adults who donated a kidney at the University Hospital Hannover. Data regarding diastolic, systolic, mean blood pressure, renal function, and proteinuria at baseline and post-donation follow-up visits were recorded. A Mann-Whitney U test was performed to compare the post-nephrectomy development of blood pressure, estimated glomerular filtration rate (eGFR), and proteinuria between men and women, hypertensives and normotensives, and older (≥65 years) and younger (<65 years) donors. Multivariable time-dependent Cox regression models were used to evaluate eGFR decline post-donation, after adjustment for covariates. Results: The majority of donors were female (64.5%), and 29.0% had pre-existing hypertension. The mean age at donation was 49 years, and 9.5% were older than 65 years. During a median follow-up of 3 years, no significant differences in proteinuria and change in renal function were observed between both sexes or hypertensive and normotensive donors. In contrast, older donors exhibited a faster decline in renal function. Mean eGFR (chronic kidney disease epidemiology collaboration equation) pre-donation was 99.6 ± 21.9 mL/min in younger donors and 77.6 ± 17.7 mL/min in older donors (P <.001). The respective mean values at the last follow-up visit were 81.3 ± 24.0 and 46.8 ± 17.9 mL/min (P <.001). After adjustment for sex and preexisting hypertension, compared to younger donors, older donors had a 2.39 hazard ratio for eGFR decline. Conclusion: Older adults display a faster decline in renal function after donation and thus should be carefully evaluated for suitability before donation.
AB - Context: Living kidney donation is considered a safe procedure with excellent outcomes. The great demand for organs has changed the suitability criteria for donation and older or hypertensive donors are increasingly accepted. Methods: We reviewed the charts of 200 adults who donated a kidney at the University Hospital Hannover. Data regarding diastolic, systolic, mean blood pressure, renal function, and proteinuria at baseline and post-donation follow-up visits were recorded. A Mann-Whitney U test was performed to compare the post-nephrectomy development of blood pressure, estimated glomerular filtration rate (eGFR), and proteinuria between men and women, hypertensives and normotensives, and older (≥65 years) and younger (<65 years) donors. Multivariable time-dependent Cox regression models were used to evaluate eGFR decline post-donation, after adjustment for covariates. Results: The majority of donors were female (64.5%), and 29.0% had pre-existing hypertension. The mean age at donation was 49 years, and 9.5% were older than 65 years. During a median follow-up of 3 years, no significant differences in proteinuria and change in renal function were observed between both sexes or hypertensive and normotensive donors. In contrast, older donors exhibited a faster decline in renal function. Mean eGFR (chronic kidney disease epidemiology collaboration equation) pre-donation was 99.6 ± 21.9 mL/min in younger donors and 77.6 ± 17.7 mL/min in older donors (P <.001). The respective mean values at the last follow-up visit were 81.3 ± 24.0 and 46.8 ± 17.9 mL/min (P <.001). After adjustment for sex and preexisting hypertension, compared to younger donors, older donors had a 2.39 hazard ratio for eGFR decline. Conclusion: Older adults display a faster decline in renal function after donation and thus should be carefully evaluated for suitability before donation.
UR - http://www.scopus.com/inward/record.url?scp=85062866207&partnerID=8YFLogxK
U2 - 10.1016/j.transproceed.2019.01.015
DO - 10.1016/j.transproceed.2019.01.015
M3 - Article
C2 - 30879551
AN - SCOPUS:85062866207
VL - 51
SP - 396
EP - 404
JO - Transplantation proceedings
JF - Transplantation proceedings
SN - 0041-1345
IS - 2
ER -