Long term results of kidney donors

Introduction: The most selective treatment method in end-stage renal failure (ESRD) is considered to be kidney transplantation due to its survival and quality of life advantages. Kidney transplants can be performed from living or cadaveric organs. In our country, transplantation from living donors is common. However, potential changes that may occur after nephrectomy may be associated with negative long-term outcomes for donors. An increased risk of kidney disease and hypertension has been reported in long-term follow-up in kidney donors. The aim of our study is to evaluate the long-term follow-up and results of kidney donors. Method: Donors who donated kidneys at Ankara University Faculty of Medicine between January 2011 and November 2022 were examined by retrospective file scanning. During the follow-up, renal functions were examined for cardiac events, death, hypertension, diabetes development, and end-stage renal failure. Results: In the specified time period, 232 of 379 donors (61.2%) could be followed up. Of the 232 donors whose data were available, 144 were women (62.1%) and 88 were men (37.9%). The mean age at the time of transplantation was 49+/-10 years (median age: 48(24- 73)). The mean GFR value at the time of transplantation was 103.68+/-10.70 mL/min/1.73 m2 in the entire group according to the CKD-EPI formula. When post-transplant GFR values were examined, the number of patients whose GFR value decreased from 60 mL/min to 1.73 m2 during the follow-up period was observed to be 42 (18.1%). In 2 patients (0.86%), GFR was between 30-45 mL/min/1.73 m2. GFR was not below 30 mL/min/1.73 m2 in any patient. No patient developed a need for chronic RRT. While the average age of the group with GFR below 60 mL/min/1.73 m2 was 55.23+/-10.69 at the time of transplantation, the average age of the group with GFR above 60 mL/min/1.73 m2 was 47.98+/-10,20 (p: <0.001). When we look at the smoking rates of donors, 40.9% of men (n: 36) and 11.8% of women (n: 17) were smokers. Obesity was observed in 64 (32.2%) of 199 donors whose height and body weights were available. 17 male (21.5%) and 47 (39.2%) female donors had obesity. It was observed that 8 donors (3.4%) were diagnosed with DM after transplantation. Post-transplant hypertension developed in 26 (11.2%) people. The hypertension rate was 19.3% (n:17) in men and 22.2% (n:32) in women. The median follow-up period of 232 donors was 6 years (4-9) and the total follow-up period was 1538 patient-years. During the total follow-up period, 4 deaths were recorded. Median year of death was 6 years (5-7 years). None of the causes of death were cardiovascular. The number of donors experiencing major cardiac adverse events after transplantation was 10 (4.3%), and the major cardiac adverse event occurred in the median 7th year (3-11 years). The frequency of HT in ASCVD patients was observed as 58.8% (n:10). Conclusion: In our study, a higher rate of obesity and CKD was observed in the donor group compared to the normal population. Although no kidney donor has developed end-stage renal disease, it is noteworthy that there is an increase in the number of patients considered to have chronic kidney disease due to the loss of GFR. Mortality rates, ASCVD and need for RRT were similar to those in the normal population.