Risks for donors associated with living kidney donation: meta-analysis
File(s)
Published version
Author(s)
Bellini, Maria Irene
Nozdrin, Mikhail
Pengel, Liset
Knight, Simon
Papalois, Vassilios
Type
Journal Article
Abstract
Background
Living kidney donation risk is likely to differ according to donor’s demographics. We aimed to analyse the effects of age, sex, body mass index (BMI) and ethnicity.
Methods
A systematic review and meta-analysis was undertaken of the effects of preoperative patient characteristics on donor kidney function outcomes, surgical complications, and hypertension.
Results
5129 studies were identified, of which 31 met the inclusion criteria, mainly from the USA and Europe. The estimated glomerular filtration rate (eGFR) in donors aged over 60 years was a mean of 9.54 ml per min per 1.73 m2 lower than that of younger donors (P < 0.001). Female donors had higher relative short- and long-term survival. BMI of over 30 kg/m2 was found to significantly lower the donor’s eGFR 1 year after donation: the eGFR of obese donors was lower than that of non-obese patients by a mean of −2.70 (95 per cent c.i. −3.24 to −2.15) ml per min per 1.73 m2 (P < 0.001). Obesity was also associated with higher blood pressure both before and 1 year after donation, and a higher level of proteinuria, but had no impact on operative complications. In the long term, African donors were more likely to develop end-stage renal disease than Caucasians.
Conclusion
Obesity and male sex were associated with inferior outcomes. Older donors (aged over 60 years) have a larger eGFR decline than younger donors, and African donors have a higher incidence of ESRD than Caucasians.
Living kidney donation risk is likely to differ according to donor’s demographics. We aimed to analyse the effects of age, sex, body mass index (BMI) and ethnicity.
Methods
A systematic review and meta-analysis was undertaken of the effects of preoperative patient characteristics on donor kidney function outcomes, surgical complications, and hypertension.
Results
5129 studies were identified, of which 31 met the inclusion criteria, mainly from the USA and Europe. The estimated glomerular filtration rate (eGFR) in donors aged over 60 years was a mean of 9.54 ml per min per 1.73 m2 lower than that of younger donors (P < 0.001). Female donors had higher relative short- and long-term survival. BMI of over 30 kg/m2 was found to significantly lower the donor’s eGFR 1 year after donation: the eGFR of obese donors was lower than that of non-obese patients by a mean of −2.70 (95 per cent c.i. −3.24 to −2.15) ml per min per 1.73 m2 (P < 0.001). Obesity was also associated with higher blood pressure both before and 1 year after donation, and a higher level of proteinuria, but had no impact on operative complications. In the long term, African donors were more likely to develop end-stage renal disease than Caucasians.
Conclusion
Obesity and male sex were associated with inferior outcomes. Older donors (aged over 60 years) have a larger eGFR decline than younger donors, and African donors have a higher incidence of ESRD than Caucasians.
Date Issued
2022-08-01
Date Acceptance
2022-03-21
Citation
British Journal of Surgery, 2022, 109 (8), pp.671-678
ISSN
0007-1323
Publisher
Wiley
Start Page
671
End Page
678
Journal / Book Title
British Journal of Surgery
Volume
109
Issue
8
Copyright Statement
© The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/ licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/35612960
PII: 6591555
Subjects
COMPLICATIONS
DIALYSIS
GENDER
IMPACT
Life Sciences & Biomedicine
NEPHRECTOMY
OBESITY
OUTCOMES
Science & Technology
STAGE RENAL-DISEASE
Surgery
SURVIVAL
TRANSPLANTATION
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2022-05-25