Long-term follow-up of kidney donors: a longitudinal study

Saran, Rajiv; Marshall, Sally M.; Madsen, Richard; Keavey, P. M.; Tapson, J. S.

doi:10.1093/ndt/12.8.1615

Cited by 123 publications

(78 citation statements)

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“…In a rat model of oligonephronia induced in utero by gentamicin and using descriptive histological techniques only, mesangial lesions and glomerular sclerosis were more common than in control animals at 24 months [31]. A parallel may be drawn with renal transplant donors, where longitudinal studies have shown no adverse effects in the early years after nephrectomy [32] but an increased prevalence of microalbuminuria and hypertension after 12-31 years [33].…”

Section: Discussionmentioning

confidence: 96%

The effect of intrauterine environment and low glomerular number on the histological changes in diabetic glomerulosclerosis

et al. 2005

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Aims/hypothesis: We tested the hypothesis that diabetic glomerulosclerosis would develop more rapidly in animals with fewer glomeruli. Methods: We studied the female offspring of Wistar rats that had been fed a low-protein diet (LPD) containing 6% protein or a normal-protein diet (NPD) containing 18% protein during pregnancy. Streptozotocin diabetes was induced at 12 weeks and animals were killed at 40 weeks. Results: Non-diabetic LPD offspring were of lower birthweight than the NPD offspring (5.19± 0.64 vs 6.45±0.67 g, p<0.001) and had fewer glomeruli (27,402±3,137 vs 34,203±6,471, p<0.05). Glomerular volume correlated inversely with glomerular number (r=−0.64, p=0.035), but total glomerular filtration surface area was reduced in the LPD animals (4,770±541 vs 5,779±1,302 mm 2 , p=0.05). Other renal structural and functional parameters were similar. In LPD and NPD diabetic animals, glomerular volume and basement membrane width were significantly increased compared to their respective controls. Podocyte density was lowest in the LPD diabetic animals (not significant), and the area covered by each podocyte was greater in the LPD diabetic group (2.40±0.693 ×10 −3 mm 2 ) than in the LPD control group (1.68±0.374 ×10 −3 mm 2 , p<0.001) and in the NPD diabetic animals (1.71±0.291 ×10 −3 mm 2 , p<0.05). There was no difference in any other structural or functional parameter between the LPD and NPD diabetic animals. Conclusions/ interpretation: A decrease in glomerular number was not deleterious to renal structure and function over 40 weeks in this animal model. Further work in models with progressive renal impairment and hypertension is necessary to clarify the impact of glomerular number on the development of renal disease.

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Section: Discussionmentioning

confidence: 96%

The effect of intrauterine environment and low glomerular number on the histological changes in diabetic glomerulosclerosis

et al. 2005

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“…Studies that have compared early with late postdonation function have found no difference in mean function in the sample of donors (49,50). In fact, a study by Saran et al (49), which compared 51 Cr EDTA early postdonation and then 10 yr later, found that the mean GFR had actually improved slightly at a follow-up of 20 yr.…”

Section: Renal Failurementioning

confidence: 95%

Medical Risks in Living Kidney Donors

Ommen¹,

Winston²,

Murphy³

2006

Clinical Journal of the American Society of Nephrology

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“…A longitudinal study over 10 years did show an increased prevalence of hypertension in donors when compared with age/sex-matched data from epidemiological studies of the general population (both in the UK and the US). 30 The prevalence of hypertension was 36% at an initial visit 1-21 years after donation, increasing to 75% after 10 years. This effect was especially strong in those donating over the age of 55 years.…”

Section: Risk Of Hypertension After Kidney Donationmentioning

confidence: 97%

“…28,29 Long-term longitudinal studies comparing early and late post-donation GFR have found no evidence of a further decline in mean function over periods of between 10 and 30 years. 30 In a meta-analysis of 48 cross-sectional studies involving over 3000 donors and 1703 controls, uninephrectomy was associated with a reduction in GFR of 17.1 ml min À1 per 1.73 m 2 (95% CI À20.2 to À14.0 ml min À1 per 1.73 m 2 ) that tended to improve slightly with each 10 years of follow-up. 31 These findings are difficult to interpret as GFR was measured by a variety of methods, including creatinine clearance by timed collection and estimated values derived from serum creatinine concentration, both of which are known to be inaccurate particularly at the modestly subnormal GFR levels expected after donation.…”

Section: Renal Function After Kidney Donationmentioning

confidence: 99%

Understanding the effects of chronic kidney disease on cardiovascular risk: are there lessons to be learnt from healthy kidney donors?

et al. 2011

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Chronic kidney disease (CKD) is now a recognized global public health problem. It is highly prevalent and strongly associated with hypertension and cardiovascular disease (CVD); far more patients with a glomerular filtration rate below 60 ml min À1 per 1.73 m 2 will die from cardiovascular causes than progress to end-stage renal disease. A better understanding of the complex mechanisms underlying the development of CVD among CKD patients is required if we are to begin devising therapy to prevent or reverse this process. Observational studies of CVD in CKD are difficult to interpret because renal impairment is almost always accompanied by confounding factors. These include the underlying disease process itself (for example, diabetes mellitus and systemic vasculitis) and the complications of CKD, such as hypertension, anaemia and inflammation. Kidney donors provide an ideal opportunity to study healthy subjects without manifest vascular disease who experience an acute change from having normal to modestly impaired renal function at the time of uninephrectomy. Prospectively examining the cardiovascular consequences of uninephrectomy using donors as a model of CKD may provide useful insight into the pathophysiology of CVD in CKD and, therefore, into how the CVD risk associated with renal impairment might eventually be reduced.

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Long-term follow-up of kidney donors: a longitudinal study

Cited by 123 publications

References 0 publications

The effect of intrauterine environment and low glomerular number on the histological changes in diabetic glomerulosclerosis

The effect of intrauterine environment and low glomerular number on the histological changes in diabetic glomerulosclerosis

Medical Risks in Living Kidney Donors

Understanding the effects of chronic kidney disease on cardiovascular risk: are there lessons to be learnt from healthy kidney donors?

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