A prospective observational study of changes in renal function and cardiovascular risk following living kidney donation.
The effect of unilateral nephrectomy on the cardiovascular risk profile of living kidney donors has not been prospectively studied. We performed an observational cohort study of 58 living donors to 6 months postdonation for changes in 24-hr ambulatory blood pressure profiles, renal function, urine protein excretion, body mass index, glucose tolerance, and fasting lipid profiles. The 24-hr systolic blood pressure average and night-day ratio were unchanged from pre- to postdonation (118.9+/-11 vs. 118.1+/-14 mm Hg, P=0.77; 0.87+/-0.07 vs. 0.87+/-0.09, P=0.68, respectively). Estimated glomerular filtration rate declined from 91.9+/-16 to 61.6+/-12 mL/min/1.73 m2 (P<0.0001). Protein excretion, body mass index, glucose, and lipids were unchanged. No significant differences were noted between dippers and nondippers either pre- or postdonation. In summary, living kidney donation in the short term is safe. We suggest further observation of individuals with lower glomerular filtration rate for possible increased cardiovascular risk factors in the future.
Prasad
G V Ramesh
GV
Division of Nephrology, University of Toronto, St. Michael's Hospital, Toronto, ON, Canada. prasadr@smh.toronto.on.ca
Lipszyc
Deborah
D
Huang
Michael
M
Nash
Michelle M
MM
Rapi
Lindita
L
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002320:Cardiovascular Physiological Phenomena; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D007668:Kidney / Q000502:physiology*; D016030:Kidney Transplantation; D008055:Lipids / Q000097:blood; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects*; D011446:Prospective Studies; D011507:Proteinuria / Q000503:physiopathology; D012307:Risk Factors
D001786:Blood Glucose; D008055:Lipids