Long-term medical outcomes among Aboriginal living kidney donors.
BACKGROUND
It is unknown whether favorable long-term data on the safety of living kidney donation can be extrapolated to populations at higher risk of chronic kidney disease. Indigenous people (i.e., Aboriginals) have a high prevalence of risk factors for chronic kidney disease and Aboriginal living donor outcomes need to be defined.


METHODS
We performed a retrospective cohort study of all 38 Aboriginal donors donating at our center since 1970 and 76 randomly selected white donor controls to determine the long-term rates of hypertension, diabetes, and renal function postdonation.


RESULTS
Follow-up was obtained for 91% of both Aboriginal and white donors (mean follow-up approximately 14 years). Hypertension has been diagnosed more frequently among Aboriginal donors (Ab 42% vs. white 19%, P=0.02). Notably, all 11 Aboriginal donors more than 20 years postdonation have developed hypertension. Diabetes has also been diagnosed more frequently among Aboriginal donors (Ab 19% vs. white 2%, P=0.005), including 5 of 11 (45%) more than 20 years postdonation. Follow-up estimated glomerular filtration rate was higher in Aboriginal donors (Ab 77+/-17 vs. white 67+/-13 mL/min/1.73 m, P=0.002) but not significantly different in adjusted analyses. One Aboriginal donor developed end-stage renal disease 14 years postdonation.


CONCLUSIONS
Aboriginal living kidney donors at our center have high rates of hypertension and diabetes on long-term follow-up, although renal function is preserved to date. This profile is similar to that of the general unselected Aboriginal population despite detailed medical evaluation before donation. These findings have important implications for donor counseling and may have implications for other high-risk donor populations.
Storsley
Leroy J
LJ
Department of Medicine, University of Manitoba, Winnipeg, MB, Canada.
Young
Ann
A
Rush
David N
DN
Nickerson
Peter W
PW
Ho
Julie
J
Suon
Vuthana
V
Karpinski
Martin
M
D001835:Body Weight; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007198:Indians, North American; D016030:Kidney Transplantation / Q000502:physiology*; D019520:Living Donors; D008297:Male; D008350:Manitoba; D008875:Middle Aged; D009864:Ontario; D010290:Parents; D011507:Proteinuria / Q000453:epidemiology; D035781:Siblings; D016896:Treatment Outcome
D003404:Creatinine