Better information is accumulating on the risks of living kidney donation. A meta-analysis has just been published January 30 in the Annals of Internal Medicine. It reports what the authors consider to be very moderately increased risk of kidney failure, and of pregnancy complications.
Mid- and Long-Term Health Risks in Living Kidney Donors
A Systematic Review and Meta-analysis
by Linda M. O’Keeffe, PhD*; Anna Ramond, DPharm*; Clare Oliver-Williams, PhD; Peter Willeit, MD; Ellie Paige, PhD;Patrick Trotter, MBChB; Jonathan Evans, MBChB; Jonas Wadstrom, MD; Michael Nicholson, MD; Dave Collett, PhD; and Emanuele Di Angelantonio, MD
From the Abstract:
"Although living kidney donation is associated with higher RRs [relative risks] for ESRD and preeclampsia, the absolute risk for these outcomes remains low. Compared with nondonor populations, living kidney donors have no increased risk for other major chronic diseases, such as type 2 diabetes, or for adverse psycho-social outcomes."
And from the concluding discussion:
"Findings from this review may have implications for policies and practices related to living kidney donation. For example, donors should be informed that, although nephrectomy is associated with a higher RR for ESRD,the absolute risk is still low for most donors (that is, those not from known high-risk populations [39]). Thus, risk prediction tools for ESRD may better approximate the risks involved for prospective donors (43). Guidelines that do not contain information about pregnancy for living kidney donors should instead include relevant information for women of childbearing age in the informed consent process. Furthermore, this review supports the need for long-term follow-up of donors to monitor their health and mitigate possible increases in disease risks associated with kidney donation (44). In conclusion, compared with nondonor populations, living kidney donors have no increased risk for several major chronic diseases, with the exception of ESRD. However, the absolute risk for this disease remains low. Female donors who become pregnant after nephrectomy also seem to be at increased risk for preeclampsia, but more data are needed to confirm this finding."
Mid- and Long-Term Health Risks in Living Kidney Donors
A Systematic Review and Meta-analysis
by Linda M. O’Keeffe, PhD*; Anna Ramond, DPharm*; Clare Oliver-Williams, PhD; Peter Willeit, MD; Ellie Paige, PhD;Patrick Trotter, MBChB; Jonathan Evans, MBChB; Jonas Wadstrom, MD; Michael Nicholson, MD; Dave Collett, PhD; and Emanuele Di Angelantonio, MD
From the Abstract:
"Although living kidney donation is associated with higher RRs [relative risks] for ESRD and preeclampsia, the absolute risk for these outcomes remains low. Compared with nondonor populations, living kidney donors have no increased risk for other major chronic diseases, such as type 2 diabetes, or for adverse psycho-social outcomes."
And from the concluding discussion:
"Findings from this review may have implications for policies and practices related to living kidney donation. For example, donors should be informed that, although nephrectomy is associated with a higher RR for ESRD,the absolute risk is still low for most donors (that is, those not from known high-risk populations [39]). Thus, risk prediction tools for ESRD may better approximate the risks involved for prospective donors (43). Guidelines that do not contain information about pregnancy for living kidney donors should instead include relevant information for women of childbearing age in the informed consent process. Furthermore, this review supports the need for long-term follow-up of donors to monitor their health and mitigate possible increases in disease risks associated with kidney donation (44). In conclusion, compared with nondonor populations, living kidney donors have no increased risk for several major chronic diseases, with the exception of ESRD. However, the absolute risk for this disease remains low. Female donors who become pregnant after nephrectomy also seem to be at increased risk for preeclampsia, but more data are needed to confirm this finding."
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