The health of living kidney donors 20 years after donation

Iglesias-Márquez, R.A; Calderon, Silvia N.; Santiago-Delpín, Eduardo A.; Rivé-Mora, E; Gonzalez-Caraballo, Z.; Morales-Otero, L.

doi:10.1016/s0041-1345(00)02781-0

Cited by 18 publications

(13 citation statements)

References 14 publications

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“…Our results should not be assumed to extend to other population groups, particularly African Americans. Follow-up studies of living kidney donors, including recent surveys of donors monitored for 20 to 30 yr, did not identify higher than expected risks of either kidney disease or other types of morbidity (4,42,43). Remarkably, older donors demonstrated the ability to develop compensatory hypertrophy to a similar degree, compared with younger donors (19).…”

Section: Discussionmentioning

confidence: 96%

Blood Pressure Evaluation among Older Living Kidney Donors

Textor

Taler

Larson

et al. 2003

Journal of the American Society of Nephrology

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Abstract. With more patients reaching end-stage renal disease, the demand for living kidney donation is increasing rapidly. Many potential donors are now in older age groups. The effects of increasing BP with age and the measurement criteria for hypertension in this group are not well defined. A total of 238 potential donors between 18 and 72 yr of age were prospectively studied, with a comparison of "clinic" BP values measured in the outpatient clinic with an oscillometric recorder (Dinamap; Critikon), ambulatory BP monitoring (ABPM) findings, and standardized BP values determined by nurses using American Heart Association criteria. Renal function was evaluated on the basis of iothalamate clearance (GFR) and urinary protein and microalbumin excretion. Ninety-six percent of subjects were Caucasian. All subjects exhibited normal GFR and urinary protein excretion. Three age groups were defined (group I, Յ35 yr, n ϭ 64; group II, 36 to 49 yr, n ϭ 109; group III, Ն50 yr, n ϭ 65). BP increased with age, as determined with all methods. Subjects Ն50 yr of age exhibited the highest clinic readings (145 Ϯ 2/83 Ϯ 1 mmHg, compared with 129 Ϯ 2/76 Ϯ 1 mmHg for group I, P Ͻ 0.01). Awake ABPM and nurse-determined BP measurements were lower than clinic readings, including those for group III (131 Ϯ 2/80 Ϯ 1 mmHg, compared with 145 Ϯ 2/83 Ϯ 1 mmHg in the clinic, P Ͻ 0.001). With the use of systolic BP values of Ͼ140 mmHg and/or diastolic BP values of Ͼ90 mmHg, 36.7% of subjects were initially considered hypertensive; this proportion decreased to 11% overall with awake ABPM findings (Ͼ135/85 mmHg). Measurement variability (SD in ABPM) and the effects of misclassification were greatest for donors Ն50 yr of age. Multivariate regression indicated that GFR of both donors and recipients decreased with age, but regression identified no independent effect of BP. Recipient outcomes for up to 2 yr were equally good for donor kidneys considered normotensive or hypertensive on the basis of clinic BP measurements. These data indicate that higher arterial BP with age can lead to misclassification of many older living kidney donors. Sixtytwo subjects with excellent kidney function were misclassified as hypertensive with clinic oscillometric measurements alone. Detailed evaluations of ABPM findings, GFR, and urinary protein levels are warranted for Caucasian subjects with high clinic BP readings who are otherwise suitable potential donors.

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Section: Discussionmentioning

confidence: 96%

Blood Pressure Evaluation among Older Living Kidney Donors

Textor

Taler

Larson

et al. 2003

Journal of the American Society of Nephrology

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“…In several studies, measurement was not standardized, or results were determined by patient self-report (13,17,19,24,39,40), thereby increasing chances of measurement errors and decreasing the chance of detecting a true difference in BP or hypertension in donors. The definition of hypertension has changed over time, and early studies (11,12,14,18,23) used cutoff points for hypertension that would not be considered acceptable today, whereas other studies (14,41,42) provided no definition of hypertension. Further complicating these studies is a prevalence of white-coat hypertension of 20 to 43% in potential kidney donors (4,43,44).…”

Section: Limitations In Measurementmentioning

confidence: 99%

Medical Risks in Living Kidney Donors

Ommen¹,

Winston²,

Murphy³

2006

Clinical Journal of the American Society of Nephrology

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“…(Hakim et al, 1984;Thorner et al, 1984) Other studies show normal blood pressures ranges after 20 years of follow up in healthy kidney donors. (Goldfarb et al, 2001;Iglesias-Marquez et al, 2001) These individuals however, seem more healthy than the general population in first place. It seems more likely that hypertension is an additional factor in the pathway of impaired renal function in low birth weights.…”

Section: Hyperfiltration Theorymentioning

confidence: 94%