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Bellos I, Pergialiotis V. Risk of pregnancy complications in living kidney donors: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2022; 270:35-41. [PMID: 35016135 DOI: 10.1016/j.ejogrb.2021.12.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 12/26/2021] [Accepted: 12/28/2021] [Indexed: 11/30/2022]
Abstract
Living kidney donation is associated with glomerular hyperfiltration, predisposing for the development of chronic kidney disease. The present meta-analysis aims to gather current evidence and clarify whether kidney donors are at increased risk of future pregnancy complications. Medline, Scopus, Web of Science, CENTRAL and Google Scholar were systematically searched from inception to August 29, 2021. Observational studies comparing the rates of adverse pregnancy outcomes among kidney donors and non-donors were selected. Random-effects models were fitted to provide meta-analysis estimates, while the quality of evidence was appraised with the Grading of Recommendations Assessment, Development and Evaluation approach. Five studies were included, comprising 430 donors and 23,540 non-donors. Living kidney donation was associated with significantly higher risk of preeclampsia (OR: 2.86, 95% CI: 1.62-5.05, moderate quality of evidence), gestational hypertension (OR: 2.53, 95% CI: 1.11-5.74, low quality of evidence) and preterm birth (OR: 1.32, 95% CI: 1.01-1.74, moderate quality of evidence). The anticipated absolute rates of preeclampsia, gestational hypertension and preterm birth were 7.4%, 5.4% and 8.3%, respectively. The risk of gestational diabetes, cesarean delivery, low birthweight and fetal death was similar between the two groups (low quality of evidence). In conclusion, women with history of kidney donation are at significantly increased risk of preeclampsia, gestational hypertension and preterm birth in subsequent pregnancies, although the absolute rate of complications remains below 10%. Future studies should confirm these effects and improve potential donor counseling by individualizing the risk of adverse perinatal outcomes.
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Affiliation(s)
- Ioannis Bellos
- Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, Athens University Medical School, National and Kapodistrian University of Athens, Greece.
| | - Vasilios Pergialiotis
- Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, Athens University Medical School, National and Kapodistrian University of Athens, Greece
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2
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Ferro CJ, Townend JN. Risk for subsequent hypertension and cardiovascular disease after living kidney donation: is it clinically relevant? Clin Kidney J 2021; 15:644-656. [PMID: 35371443 PMCID: PMC8967677 DOI: 10.1093/ckj/sfab271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Indexed: 11/17/2022] Open
Abstract
The first successful live donor kidney transplant was performed in 1954. Receiving a kidney transplant from a live kidney donor remains the best option for increasing both life expectancy and quality of life in patients with end-stage kidney disease. However, ever since 1954, there have been multiple questions raised on the ethics of live kidney donation in terms of negative impacts on donor life expectancy. Given the close relationship between reduced kidney function in patients with chronic kidney disease (CKD) and hypertension, cardiovascular disease and cardiovascular mortality, information on the impact of kidney donation on these is particularly relevant. In this article, we review the existing evidence, focusing on the more recent studies on the impact of kidney donation on all-cause mortality, cardiovascular mortality, cardiovascular disease and hypertension, as well as markers of cardiovascular damage including arterial stiffness and uraemic cardiomyopathy. We also discuss the similarities and differences between the pathological reduction in renal function that occurs in CKD, and the reduction in renal function that occurs because of a donor nephrectomy. Kidney donors perform an altruistic act that benefits individual patients as well as the wider society. They deserve to have high-quality evidence on which to make informed decisions.
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Affiliation(s)
- Charles J Ferro
- Institute of Cardiovascular Sciences, University of Birmingham, UK
- Department of Renal Medicine, Queen Elizabeth Hospital, Birmingham, UK
| | - Jonathan N Townend
- Institute of Cardiovascular Sciences, University of Birmingham, UK
- Department of Cardiology, Queen Elizabeth Hospital, Birmingham, UK
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3
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Díaz-De la Cruz EN, Cerrillos-Gutiérrez JI, García-Sánchez A, Andrade-Sierra J, Cardona-Muñoz EG, Rojas-Campos E, González-Espinoza E, Miranda-Díaz AG. The Alteration of Pro-inflammatory Cytokines and Oxidative Stress Markers at Six-Month Post-living Kidney Donation. Front Med (Lausanne) 2020; 7:382. [PMID: 32850897 PMCID: PMC7403208 DOI: 10.3389/fmed.2020.00382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 06/19/2020] [Indexed: 12/02/2022] Open
Abstract
Donors have a higher risk of developing chronic kidney disease than the general population. Some mechanisms mediated by pro-inflammatory cytokines and oxidative stress may be involved as risk factors. The objective of the study was to evaluate the behavior of pro-inflammatory cytokines and oxidative stress markers in living renal donors with a 6-month follow-up. A single prospective cohort was performed in 88 renal donors. At the end of the follow-up, the levels of lipoperoxides, 6.52 ± 1.12 mM, and 8-isoprostanes, 63.75 ± 13.28 pg/mL, were lower than before donation, 10.20 ± 3.95 mM (p < 0.001) and 67.54 ± 9.64 pg/mL (p = 0.026), respectively. Initial levels of nitric oxide (NO), 356.09 ± 59.38 μM increased at the end of the follow-up, 467.08 ± 38.74 μM (p < 0.001). It was observed in the final determination of donors decreased activity of antioxidant enzymes superoxide dismutase (SOD), 0.74 ± 0.57 U/L and glutathione peroxidase (GPx), 556.41 ± 80.37 nmol, in comparison with the levels obtained in the initial determination, 1.05 ± 0.57 U/L (p < 0.001) and 827.93 ± 162.78 nmol (p < 0.001), respectively. The pro-inflammatory cytokines, Tumor necrosis factor alpha and interleukin-6 showed no differences at 6 months after donation. The enzyme oxoguanine glycosylase (hOGG1) responsible for repairing oxidative damage to DNA, showed a decrease in its concentration at the end of the study in donor men, 0.40 ± 0.21 ng/mL compared to the initial levels, 0.55 ± 0.32 ng/mL (p = 0.025). The marker, 8-hydroxy-2-deoxyguanosine (8-OHdG) exhibited an increase in donor men at the final determination 2.28 ± 1.99 ng/mL, compared to the concentration before donation, 1.72 ± 1.96 ng/mL (p < 0.001). We found significant changes in the markers of the oxidative state with increased NO and 8-OHdG, as well as a significant decrease in the antioxidant defenses SOD, GPx, and in the DNA repair enzyme in living renal donors after 6 months of follow-up.
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Affiliation(s)
- Elodia Nataly Díaz-De la Cruz
- Department of Physiology, Institute of Experimental and Clinical Therapeutics, University Center of Health Sciences, University of Guadalajara, Guadalajara, Mexico
| | - José Ignacio Cerrillos-Gutiérrez
- Department of Nephrology and Transplants, Specialties Hospital, National Occidental Medical Centre, The Mexican Social Security Institute, Guadalajara, Mexico
| | - Andrés García-Sánchez
- Department of Physiology, Institute of Experimental and Clinical Therapeutics, University Center of Health Sciences, University of Guadalajara, Guadalajara, Mexico
| | - Jorge Andrade-Sierra
- Department of Nephrology and Transplants, Specialties Hospital, National Occidental Medical Centre, The Mexican Social Security Institute, Guadalajara, Mexico
| | - Ernesto Germán Cardona-Muñoz
- Department of Physiology, Institute of Experimental and Clinical Therapeutics, University Center of Health Sciences, University of Guadalajara, Guadalajara, Mexico
| | - Enrique Rojas-Campos
- Kidney Diseases Medical Research Unit, Specialties Hospital, National Occidental Medical Centre, Mexican Social Security Institute, Guadalajara, Mexico
| | - Eduardo González-Espinoza
- Department of Nephrology and Transplants, Specialties Hospital, National Occidental Medical Centre, The Mexican Social Security Institute, Guadalajara, Mexico
| | - Alejandra Guillermina Miranda-Díaz
- Department of Physiology, Institute of Experimental and Clinical Therapeutics, University Center of Health Sciences, University of Guadalajara, Guadalajara, Mexico
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4
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Nunes-Carneiro D, Madanelo M, Silva F, Pestana N, Ribeiro C, Gil-Sousa D, Martins LS, Almeida M, Dias L, Malheiro J, Cavadas V, Castro-Henriques A, Fraga A, Silva-Ramos M. Remaining kidney volume indexed to weight as a strong predictor of estimated glomerular filtration rate at 1 year and mid-term renal function after living-donor nephrectomy - a retrospective observational study. Transpl Int 2020; 33:1262-1273. [PMID: 32608073 DOI: 10.1111/tri.13683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 04/27/2020] [Accepted: 06/22/2020] [Indexed: 01/10/2023]
Abstract
The donors' estimated glomerular filtration rate (eGFR) after living nephrectomy has been a concern, particularly in donors with smaller kindeys. Therefore, we developed this retrospective observational study in 195 donors to determine the ability remaining kidney volume indexed to weight (RKV/W) to predict eGFR at 1 year through multivariate linear regression and to explore this relationship between annual eGFR change from 1 to 4 years postdonation evaluated by a linear mixed model. Comparing RKV/W tertiles (T1, T2, T3), RKV/W was a good predictor of 1-year eGFR which was significantly better in T3 donors. Gender, predonation eGFR, and RKV/W were independent predictors of eGFR at 1-year. In a subgroup with predonation eGFR < 90mL/min/1.73 m2 , a significant prediction of eGFR < 60mL/min/1.73 m2 was detected in males with RKV/W ≤ 2.51cm3 /kg. Annual eGFR (ml/min/year) change from 1 to 4 years was + 0.77. RKV/W divided by tertiles (T1-T3) was the only significant predictor: T2 and T3 donors had an annual eGFR improvement opposing to T1. RKV/W was a good predictor of eGFR at 1 year, independently from predonation eGFR. A higher RKV/W was associated with improved eGFR at 1 year. A decline in eGFR on the four years after surgery was only noticeable in donors with RKV/W ≤ 2.13cm3 /kg.
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Affiliation(s)
- Diogo Nunes-Carneiro
- Urology Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal.,Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.,i3S/INEB, Universidade do Porto, Porto, Portugal
| | - Mariana Madanelo
- Urology Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal
| | - Filipa Silva
- Nephrology and Kidney Transplantation Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal
| | - Nicole Pestana
- Nephrology Department, Hospital Dr, Nelio Mendonça Funchal, Porto, Portugal
| | - Catarina Ribeiro
- Nephrology Department, Centro Hospitalar de Vila Nova de Gaia e Espinho, Porto, Portugal
| | - Diogo Gil-Sousa
- Urology Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal
| | - La Salete Martins
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.,Nephrology and Kidney Transplantation Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal
| | - Manuela Almeida
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.,Nephrology and Kidney Transplantation Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal
| | - Leonídio Dias
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.,Nephrology and Kidney Transplantation Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal
| | - Jorge Malheiro
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.,Nephrology and Kidney Transplantation Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal
| | - Vítor Cavadas
- Urology Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal
| | - Antonio Castro-Henriques
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.,Nephrology and Kidney Transplantation Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal
| | - Avelino Fraga
- Urology Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal.,Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.,i3S/INEB, Universidade do Porto, Porto, Portugal
| | - Miguel Silva-Ramos
- Urology Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal.,Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
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Hall IE, Shaaban A, Wei G, Sikora MB, Bourija H, Beddhu S, Shihab F. Baseline living-donor kidney volume and function associate with 1-year post-nephrectomy kidney function. Clin Transplant 2019; 33:e13485. [PMID: 30689244 PMCID: PMC6487946 DOI: 10.1111/ctr.13485] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 12/18/2018] [Accepted: 01/21/2019] [Indexed: 12/05/2022]
Abstract
Living donors may develop kidney dysfunction more often than equally healthy populations. The purpose of this study was to determine whether computed tomography-assessed remaining kidney volume indexed to body surface area (RKV/BSA) was associated with 1-year post-nephrectomy renal function independent of baseline renal function. Using multivariable regression, we modeled 1-year estimated glomerular filtration rate (eGFR) and eGFR <60 mL /min/1.73 m2 and considered pre-determined baseline eGFR subgroups in 151 consecutive donors. Mean ± SD baseline age, eGFR, RKV, BSA, and RKV/BSA were 38 ± 11 years, 97 ± 16 mL/min/1.73 m2 , 153 ± 29 mL, 1.9 ± 0.2 m2 , and 80.0 ± 12.8 ml/m2 , respectively; 50% were female and 94% were white. Mean baseline eGFR was greater with increasing RKV/BSA tertiles (92 ± 14, 97 ± 16, 107 ± 16 mL/min/1.73 m2 ; P < 0.001). Post-nephrectomy eGFR remained separated by RKV/BSA tertiles. At baseline, each SD greater RKV/BSA and eGFR was independently associated with higher adjusted 1-year eGFR by 2.4 and 9.2 mL/min/1.73 m2 . Each SD greater age associated with 2.2 mL/min/1.73 m2 lower adjusted 1-year eGFR. Adjusted odds of 1-year eGFR <60 increased significantly for donors with RKV/BSA <80 mL/m2 . With baseline eGFR <90, probability of 1-year eGFR <60 increased to >80% with decreasing RKV/BSA values below 80 mL/m2 . Those with baseline eGFR >100 rarely developed 1-year eGFR <60 if RKV/BSA remained >60 mL/m2 . RKV/BSA independently associated with 1-year eGFR <60, especially with lower baseline eGFRs. Additional studies should evaluate the predictive utility of this measure and its potential role in donor evaluations and informed consent.
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Affiliation(s)
- Isaac E. Hall
- Department of Internal Medicine, Division of Nephrology & HypertensionUniversity of Utah School of MedicineSalt Lake CityUtah
| | - Akram Shaaban
- Department of Radiology and Imaging Sciences, Division of Clinical RadiologyUniversity of Utah School of MedicineSalt Lake CityUtah
| | - Guo Wei
- Department of Population Health Sciences, Division of BiostatisticsUniversity of Utah School of MedicineSalt Lake CityUtah
| | - Magdalena B. Sikora
- Department of Internal Medicine, Division of Nephrology & HypertensionUniversity of Utah School of MedicineSalt Lake CityUtah
| | - Hassan Bourija
- Department of Radiology and Imaging Sciences, Division of Clinical RadiologyUniversity of Utah School of MedicineSalt Lake CityUtah
| | - Srinivasan Beddhu
- Department of Internal Medicine, Division of Nephrology & HypertensionUniversity of Utah School of MedicineSalt Lake CityUtah
- Medical ServiceVeterans Affairs Salt Lake City Health Care SystemSalt Lake CityUtah
| | - Fuad Shihab
- Department of Internal Medicine, Division of Nephrology & HypertensionUniversity of Utah School of MedicineSalt Lake CityUtah
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6
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Wang M, Zhang H, Zhou D, Qiao YC, Pan YH, Wang YC, Zhao HL. Risk for cancer in living kidney donors and recipients. J Cancer Res Clin Oncol 2018; 144:543-550. [PMID: 29356887 DOI: 10.1007/s00432-018-2590-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 01/17/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Malignancy following renal transplantation remains inconsistent with the reported safety of kidney donation during the long-term follow-up. METHODS We conducted searches of the published literature which included healthy participants, recipients, living kidney donors (LKDs), and the availability of outcome data for malignancy. Eight from 938 potentially relevant studies were analyzed by means of fixed-effects model or random-effects model, as appropriately. RESULTS In 48,950 participants, the follow-up range was 18 months to 20 years, and the mean age of the subjects was approximately 41 years. The incidence rate with 95% confidence interval (CI) for malignancy after kidney transplantation was 0.03 (0.01-0.05) in recipients and 0.03 (0.1-0.07) in LKDs, giving a pooled incidence rate of 0.03 (95% CI 0.02-0.04). LKDs contrasted nondonors by the overall odds ratio and 95% CI for total cancer of 2.80 (2.69-2.92). CONCLUSIONS Kidney transplantation was associated with an increased risk of cancer during a long-term follow-up. Long-term risk for cancer in LKDs and kidney recipients should be monitored.
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Affiliation(s)
- Min Wang
- Center for Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin, 541004, Guangxi, China
| | - Huai Zhang
- Center for Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin, 541004, Guangxi, China.,School of Public Health, Guilin Medical University, Guilin, 541004, Guangxi, China
| | - Dan Zhou
- Center for Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin, 541004, Guangxi, China
| | - Yong-Chao Qiao
- Department of Immunology, School of Basic Medicine, Central South University, Changsha, 410078, Hunan, China
| | - Yan-Hong Pan
- Center for Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin, 541004, Guangxi, China
| | - Yan-Chao Wang
- Center for Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin, 541004, Guangxi, China
| | - Hai-Lu Zhao
- Center for Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin, 541004, Guangxi, China. .,Department of Immunology, Guangxi Area of Excellence, Guilin Medical University, Huan Cheng North 2nd Road 109, Guilin, 541004, Guangxi, China.
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7
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Editorial Comment. Urology 2015; 85:1366. [PMID: 26099883 DOI: 10.1016/j.urology.2014.12.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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9
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Lam NN, Garg AX, Segev DL, Schnitzler MA, Xiao H, Axelrod D, Brennan DC, Kasiske BL, Tuttle-Newhall JE, Lentine KL. Gout after living kidney donation: correlations with demographic traits and renal complications. Am J Nephrol 2015; 41:231-40. [PMID: 25896309 DOI: 10.1159/000381291] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 02/24/2015] [Indexed: 01/07/2023]
Abstract
BACKGROUND The demographic and clinical correlates of gout after living kidney donation are not well described. METHODS Using a unique database that integrates national registry identifiers of U.S. living kidney donors (1987-2007) with billing claims from a private health insurer (2000-2007), we identified post-donation gout based on medical diagnosis codes or pharmacy fills for gout therapies. The frequencies and demographic correlates of gout after donation were estimated by Cox regression with left- and right-censoring. We also compared the rates of renal diagnoses among donors with and without gout, matched in the ratio 1:3 by age, sex, and race. RESULTS The study sample of 4,650 donors included 13.1% African Americans. By seven years, African Americans were almost twice as likely to develop gout as Caucasian donors (4.4 vs. 2.4%; adjusted hazard ratio, aHR, 1.8; 95% confidence interval (CI) 1.0-3.2). Post-donation gout risk also increased with older age at donation (aHR per year 1.05) and was higher in men (aHR 2.80). Gout rates were similar in donors and age- and sex-matched general non-donors (rate ratio 0.86; 95% CI 0.66-1.13). Compared to matched donors without gout, donors with gout had more frequent renal diagnoses, reaching significance for acute kidney failure (rate ratio 12.5; 95% CI 1.5-107.0), chronic kidney disease (rate ratio 5.0; 95% CI 2.1-11.7), and other disorders of the kidney (rate ratio 2.2; 95% CI 1.2-4.2). CONCLUSION Donor subgroups at increased risk of gout include African Americans, older donors, and men. Donors with gout have a higher burden of renal complications after demographic adjustment.
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Affiliation(s)
- Ngan N Lam
- Division of Nephrology, Western University, London, Ont., Canada
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Vergho D, Burger M, Schrammel M, Brookman-May S, Gierth M, Hoschke B, Lopau K, Gilfrich C, Riedmiller H, Wolff I, May M. Matched-pair analysis of renal function in the immediate postoperative period: a comparison of living kidney donors versus patients nephrectomized for renal cell cancer. World J Urol 2014; 33:725-31. [DOI: 10.1007/s00345-014-1423-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 10/19/2014] [Indexed: 11/29/2022] Open
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Niemi M, Mandelbrot DA. The Outcomes of Living Kidney Donation from Medically Complex Donors: Implications for the Donor and the Recipient. CURRENT TRANSPLANTATION REPORTS 2014; 1:1-9. [PMID: 24579060 PMCID: PMC3933185 DOI: 10.1007/s40472-013-0001-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Living kidney donation is an important option for patients with end-stage renal disease (ESRD), and has improved life expectancy and quality for patients otherwise requiring maintenance dialysis or deceased-donor transplantation. Given the favorable outcomes of live donation and the shortage of organs to transplant, individuals with potentially unfavorable demographic and clinical characteristics are increasingly being permitted to donate kidneys. While this trend has successfully expanded the live donor pool, it has raised concerns as to which acceptance criteria are safe. This review aims to summarize the existing literature on the outcomes of transplantation from medically complex, living kidney donors, including both donor and recipient outcomes when available.
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Affiliation(s)
- Matthew Niemi
- Division of Nephrology, Department of Medicine Beth Israel Deaconess Medical Center 185 Pilgrim Road, Farr 8 Boston, MA 02215
| | - Didier A Mandelbrot
- The Transplant Center Beth Israel Deaconess Medical Center 110 Francis Street, LMOB 7 Boston, MA 02215
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12
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Evolution of Trends in the Live Kidney Transplant Donor-Recipient Relationship. Transplant Proc 2013; 45:57-64. [DOI: 10.1016/j.transproceed.2012.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 08/28/2012] [Indexed: 01/10/2023]
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