Long-Term Renal Function in Kidney Donors: A Comparison of Donors and Their Siblings

Abstract

To assess the effects of unilateral nephrectomy, we evaluated renal function and hypertension in kidney donors who had had nephrectomies 10 years ago or more and siblings who had not had nephrectomies. No statistically significant difference was found between the prevalence of hypertension in donors and siblings. Serum creatinine concentrations were 20% higher in donors and creatinine clearances, 20% lower than corresponding values in siblings. Twenty-four-hour urinary protein excretion increased in all donors after nephrectomy and was more marked in men than women. Of the 38 donors, 12 excreted more than 150 mg/24 h of urinary protein, but only 2 excreted more than 300 mg/24 h. The presence of proteinuria did not correlate with the presence of hypertension, level of renal function, or time since nephrectomy. We conclude that, with the exception of mild proteinuria of unknown clinical significance, unilateral nephrectomy is not associated with adverse effects on kidney function.

Medical Risks in Living Kidney Donors

“…The (10,11,13,19,25). The sum of the results of these five studies can be interpreted as showing that there is likely an increase in hypertension and proteinuria in male donors and, not unexpected, a loss of renal function of at least 20% in both genders.…”

“…Furthermore, because of tubular secretion of creatinine, both serum creatinine and creatinine clearance will overestimate GFR to a greater degree as renal function declines. This may lead to underestimation of decreases in renal function and the degree of renal dysfunction after donation in studies that rely on these measurements, as the majority do (11,12,(17)(18)(19)(20)23,25,40,45,47). This is demonstrated in a study by Watnick et al (24), in which postdonation creatinine clearance was only modestly decreased at 85 ml/min per 1.73 m 2 , whereas inulin clearance was 44% lower at 66 ml/min per 1.73 m 2 .…”

“…However, studies with at least 7 yr of follow-up have shown greater levels of protein excretion in donors with higher BP or established hypertension (9 -11). Four studies of donors, including a meta-analysis by Kasiske et al (53), have shown a greater rate of proteinuria in men as compared with women (11,25,49,53).…”

Growth hormone regulation of glomerular AT1angiotensin receptors in adult uninephrectomized male rats

“…After 18, 24, or 48 h (n ϭ 5-18/group), the right kidney (i.e., remnant kidney) was removed and processed using the same procedures as the left kidney (control kidney). Kidney growth was based on wet weight because we have previously found that the increase in kidney dry weight induced by UNX is proportional to wet weight and total protein (27).…”

Long-Term Consequences of Uninephrectomy in Male and Female Rats

“…5,6 Some researchers have found an increase in BP after kidney donation, 7,8 and studies comparing donors with siblings or potential kidney donors have shown conflicting results for the impact of donation on BP, renal function, and proteinuria. 7,[9][10][11][12] It is complicated to dissociate the effects of the aging process from the influence of UNX, because both renal function and BP are influenced by age. Thus, in studies of ageand sex-matched populations, some 9,11,12 but not all 7 authors found differences in BP between kidney donors and the general population.…”