Evaluation of kidney transplant donors in terms of LONG-TERM cardiovascular and renal risks

Introduction and Aim: There are more than 27000 living-donor kidney transplantations performed each year across the world. Various studies in the literature indicate an increased risk for end stage kidney disease and hypertension in renal transplant donors. In our study, we aimed to evaluate the renal transplant donors, who are followed in Istanbul Faculty of Medicine Nephrology Clinic, for cardiovascular and renal risks. Material and Method: One hundred and eighteen subjects who donated a kidney until 31 December 2019 in Istanbul University Istanbul Faculty of Medicine and are followed in our Nephrology clinic were included in the study. Patient files were retrospectively analyzed and demographic characteristics, pre-donation laboratory values, kidney size, comorbidities, follow-up period, and their association with diseases that develop during follow-up were evaluated. Results: Out of 118 donors included, 32.2% (n=38) were male and 67.8% (n=80) were female. Mean age of donors was 57.26±10.93 and mean age at donation was 48.10±9.78. Mean follow-up was 8.23±6.16 years. During follow-up, hypertension developed in 42 donors (35.6%), diabetes mellitus in 12 donors (10.2%), proteinuria in 4 donors (3.4%), acute myocardial infarction in 2 donors (1.7%), coronary artery disease in 6 donors (5.1%), depression in 5 donors (4.2%) and a malignancy in 4 donors (5.1%). Fasting plasma glucose and serum creatinine levels were significantly higher and glomerular filtration rate (GFR) was significantly lower in all donors in the posttransplant period when compared to pretransplant period (p<0.05). Hypertension development was more common in donors with an initial GFR lower than 90, donors related to recipients were more prone to developing any disease, pre-donation smoking status was associated with a decrease in GFR and donors with longer follow-up had significantly more diseases diagnosed (p<0.05). Conclusion: Regular follow-up of donors is necessary due to cardiovascular and renal problems that may develop in the post-transplant period. Keywords: Living kidney donor, posttransplant follow-up, renal transplantation