|
 “This study highlights the low but real risks of living kidney
donation and emphasizes the importance of careful assessment and
counseling for all living donors,” senior study author Dr. Emanuele
Di Angelantonio, director of the NIHR Biomedical Research Unit in
Donor Health and Genomics at the University of Cambridge in the UK,
said by email.
Compared with non-donors, living kidney donors were almost nine
times more likely to develop end-stage renal disease (ESRD), severe
kidney failure that requires people to receive a transplant or go on
dialysis.
Each year, the absolute risk of ESRD was 0.5 cases for every 1,000
living donors, compared with 0.1 cases for every 1,000 non-donors.
Even though living kidney donation is the gold standard treatment
for patients with ESRD, much of the research on the health effects
for donors has offered an inconclusive picture of the long-term
consequences of giving away a kidney, researchers note in the Annals
of Internal Medicine.
To get a clearer picture of the lasting health effects of donation,
researchers examined data from 52 previously published studies that,
combined, included a total of 118,426 living kidney donors and
117,576 otherwise similar individuals who weren’t donors. These
smaller studies followed participants for an average of 1 to 24
years.
Overall, there was no increased risk of death from all causes
associated with being a living kidney donor, the research review
found.
Living kidney donors also didn’t appear to have an increased risk of
developing cardiovascular disease, diabetes, high blood pressure or
mental health problems.
Women did have a higher risk of preeclampsia, a serious form of high
blood pressure that can develop during pregnancy and endanger the
lives of both women and their babies when it isn’t properly treated.
Among living donors, there were 5.9 cases of preeclampsia for every
100 pregnancies, compared with 3.1 cases for every 100 pregnancies
among non-donors.
[to top of second column] |
One limitation of the study is that the control groups of non-donors
in the analysis may not have been as healthy overall as the donors
because of the stringent medical evaluations people must undergo to
qualify to become living donors, the authors note. Another drawback
is that some health problems related to donation might take decades
to develop, making them impossible to detect in this study.
“It’s safe to say that we now know a lot about what happens to
kidney donors in the first ten years after donation, but much less
about what happens later,” said Dr. Peter Reese, author of an
accompanying editorial and a researcher at the University of
Pennsylvania Perelman School of Medicine in Philadelphia.
Donors younger than 25 should be particularly cautious about the
potential long-term unknown risks of donation, since they might have
many decades of life with only one kidney, Reese said by email.
Patricia Sheiner, transplant surgeon and Director of Transplant at
Hartford Hospital in Connecticut, who wasn't involved in the study,
told Reuters Health, “Even though the risk of kidney failure is
higher in kidney donors than in the general population, the absolute
incidence is still very low. However, it’s important that people
considering donation understand the short term and long term risks.
It’s also important that transplant programs continue to carefully
select suitable donors, excluding those who are at risk for
developing conditions that could contribute to kidney problems.”
“We must keep in mind that the results might be different if donors
were followed up for 30 years,” Reese added. “It is possible that
there are small increased risks of death or cardiovascular disease
from kidney donation that were not recognized because many living
kidney donors may be selected because of their overall good health.”
SOURCES: http://bit.ly/2DLxYF3 and http://bit.ly/2GtixiJ Annals of
Internal Medicine, online January 29, 2018.
[© 2018 Thomson Reuters. All rights
reserved.] Copyright 2018 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
Thompson Reuters is solely responsible for this content. |
