Renal Function Profile in White Kidney Donors: The First 4 Decades

Ibrahim, Hassan N.; Foley, Robert N.; Reule, Scott; Spong, Richard; Kukla, Aleksandra; Issa, Naim; Berglund, Danielle; Sieger, Gretchen; Matas, Arthur J.

doi:10.1681/asn.2015091018

Cited by 106 publications

(122 citation statements)

References 19 publications

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“…Although DM accounts for approximately half of all ESRD cases in the general population, only 12% to 22% of ESRD cases in kidney donors have been attributed to DM (13, 19–23). This lower incidence of ESRD from DM in kidney donors may reflect the fact that many people who are at very high risk of DM are generally excluded from donation.…”

Section: Discussionmentioning

confidence: 99%

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Renal Consequences of Diabetes After Kidney Donation

Ibrahim

Berglund

Jackson

et al. 2017

American Journal of Transplantation

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Whether diabetes after donation is associated with an accelerated GFR decay in the remaining kidney has not been studied. We determined the incidence of diabetes in kidney donors, compared GFR change over time in diabetic to non-diabetic donors, and also the impact of DM on the development of proteinuria, hypertension and ESRD. Of the 4014 donors, 309(7.7%) developed diabetes at a median age of 56.0 years and after a median of 18 years post-donation. The difference in annual eGFR change between diabetic and non-diabetic donors in the seven years prior to DM development was −0.08 ml/min/year; p=0.51. After DM development, the difference was −1.10 ml/min/year for diabetics with hypertension and proteinuria, p<0.001; −0.19 for diabetic donors with hypertension but no proteinuria, p=0.29; −0.75 ml/min/year for diabetic donors with proteinuria but no hypertension, p=0.19 and −0.09 ml/min/year for diabetic donors without proteinuria or hypertension, p=0.63. When DM was considered as a time-dependent covariate, it was associated with the development of proteinuria (HR 2.65 (95%CI 1.89, 3.70), p<0.001) and hypertension (HR 2.19 (95%CI 1.74, 2.75), p<0.001). It was not, however, associated with ESRD. eGFR decline after DM development exceeds that of non-diabetic donors only in those with concomitant proteinuria and hypertension.

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Section: Discussionmentioning

confidence: 99%

“…Detailed account of the University of Minnesota donor program has been published previously (12, 13). Exclusion criteria for donation include any proteinuria (urinary protein >150 mg/day or urinary albumin/ creatinine >30 mg/g), body mass index (BMI) > 30 kg/m 2 unless physical examination results warranted acceptance; and diabetes.…”

Section: Methodsmentioning

confidence: 99%

Renal Consequences of Diabetes After Kidney Donation

Ibrahim

Berglund

Jackson

et al. 2017

American Journal of Transplantation

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“…17 Hassan and associates found that a higher BMI is the single predonation variable associated with every adverse postdonation outcome except for death, and each increase of 1 kg/m² is associated with a 3% to 10% higher risk of proteinuria and a reduced glomerular filtration rate. 18 Patients with a BMI > 30 kg/m² almost universally develop proteinuria after nephrectomy and have a much higher rate of chronic kidney disease than those with a BMI below this level. 17 Potential donors with a family history of type 2 diabetes (sibling or parental) have a 30% risk of developing diabetes over 5 years, and donation is usually contraindicated.…”

Section: Discussionmentioning

confidence: 99%

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Al-Rabadi¹,

Almardini

Hajeer³

et al. 2017

Exp Clin Transplant

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Objectives: Living-related kidney donation is the main source of renal grafts in Jordan, since kidneys from deceased donors are scarce. Although the Jordanian community accepts the idea of kidney donation to family members, not all potential donors manage to complete the required psychologic and medical evaluations. We review the causes of kidney-donation cancellation and suggest options to increase the number of available organs. Materials and Methods: We performed a retrospective chart review of all potential living-related kidney donors at King Hussein Medical Center between January 2008 and June 2016.Results: Of 642 potential donors, 366 (57%) were male and 276 (43%) were female, ranging in age from 18 to 66 years with a mean age of 37 years. A total of 384 (59.8%) eventually donated a kidney. A donor issue was the cause of cancellation in 143 (22.3%), whereas 47 (32.9%) had a risk for renal impairment after donation (eg, hematuria, proteinuria, stones, multiple renal cysts, scarred kidney, congenital malformation, recurrent urinary tract infection), and 30 (21%) had blood group or immunologic incompatibilities. Fifteen (10.5%) withdrew during the evaluation process, 13 (9%) had hypertension, 10 (7%) had a high body mass index, 8 (5.6%) were diabetic or prediabetic, 7 (4.9%) were surgically unsuitable, 4 (2.8%) had hepatitis B virus infection, 4 (2.8%) were pregnant, 3 (2.1%) had significant cardiovascular disease, 1 (0.7%) had splenomegaly with lymph node enlargement, and 1 (0.7%) had thyroiditis. Conclusions: Cancellation of kidney donation in Jordan is mainly for medical reasons, the most common being renal issues. Paired donation between blood group and immunologically incompatible duos may increase the number of organs available, as may good psychologic assessment and counseling of those likely to change their mind. Support should be provided for donors who drop out of donation for any cause, especially for renal and vascular issues.

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“…The authors then compared 15-year projections with the observed risk among actual living kidney donors. The observed risk of ESKD among living kidney donors was 3- to 5-fold higher than the projected risk without donation.Ibrahim et al 2016 31 This single-center study of 3,956 European American donors found that ESKD after donation was uncommon (28 donors affected) and highly correlated with post-donation development of diabetes and hypertension. The study was limited by the lack of African American donors and non-donor controls.…”

Section: Long-term Post-donation Health Risks Among Living Kidney Donorsmentioning

confidence: 98%

“…Ibrahim et al 2016 31 This single-center study of 3,956 European American donors found that ESKD after donation was uncommon (28 donors affected) and highly correlated with post-donation development of diabetes and hypertension. The study was limited by the lack of African American donors and non-donor controls.…”

Section: Long-term Post-donation Health Risks Among Living Kidney Donorsmentioning

confidence: 98%

Apolipoprotein L1 Gene Effects on Kidney Transplantation

Freedman

Locke

Reeves‐Daniel

et al. 2017

Seminars in Nephrology

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The pathogenesis of many common etiologies of nephropathy has been informed by recent molecular genetics breakthroughs. It is now apparent that the ethnic disparity in risk for non-diabetic chronic kidney disease between African Americans and European Americans is largely explained by variation in the apolipoprotein L1 gene (APOL1). Presence of two APOL1 renal-risk variants markedly increases an individual’s risk for kidney disease. In transplantation, kidneys from deceased African Americans with two APOL1 renal-risk variants have shorter survival intervals after engraftment, regardless of the ethnicity of the recipient. Precision medicine will transform the clinical practice of nephrology and kidney transplantation, and play an important role in the allocation of kidneys from deceased and living kidney donors with recent African ancestry. This article reviews existing data on APOL1 in deceased- and living-donor kidney transplantation. It considers the impact of including APOL1 genotyping in decisions on the allocation and discard of deceased-donor kidneys, as well as the selection of living donors.

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Renal Function Profile in White Kidney Donors: The First 4 Decades

Cited by 106 publications

References 19 publications

Renal Consequences of Diabetes After Kidney Donation

Renal Consequences of Diabetes After Kidney Donation

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Apolipoprotein L1 Gene Effects on Kidney Transplantation

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