title: Associations of recipient illness history with hypertension and diabetes after living kidney donation.
abstract: BACKGROUND
  Little is known about associations of family health history with outcomes after kidney donation.
  
  
  METHODS
  Using a database wherein Organ Procurement and Transplantation Network identifiers for 4650 living kidney donors in 1987 to 2007 were linked to administrative data of a US private health insurer (2000-2007 claims), we examined associations of recipient illness history as a measure of family history with postdonation diagnoses and drug-treatment for hypertension and diabetes. Cox regression with left and right censoring was applied to estimate associations (adjusted hazards ratios, aHR) of recipient illness history with postnephrectomy donor diagnoses, stratified by donor-recipient relationship.
  
  
  RESULTS
  Recipient end-stage renal disease from hypertension, as compared with other recipient end-stage renal disease causes, was associated with modest, significant increases in the age- and gender-adjusted relative risks of hypertension diagnosis (aHR, 1.37%; 95% confidence interval [CI], 1.08-1.74) after donor nephrectomy among related donors. After adjustment for age, gender, and race, recipient type 2 diabetes compared with non-diabetic recipient status was associated with twice the relative risk of postdonation diabetes (aHR, 2.14; 95% CI, 1.28-3.55; P=0.003) among related donors. These patterns were significant among white but not among non-white related donors. Recipient type 1 diabetes was associated with postdonation diabetes only in black related donors (aHR, 3.22; 95% CI, 1.04-9.98; P=0.04). Recipient illness did not correlate significantly with outcomes in unrelated donors.
  
  
  CONCLUSIONS
  These data support a need for further study of family health history as a potential sociodemographic correlate of donor outcomes, including examination of potential mediating factors and variation in risk discrimination among donors of different racial groups.
authors.affiliation: Center for Outcomes Research, Saint Louis University School of Medicine, St. Louis, MO, USA. lentinek@slu.edu
authors.forename: Krista L
authors.initials: KL
authors.lastname: Lentine
authors.forename: Mark A
authors.initials: MA
authors.lastname: Schnitzler
authors.forename: Huiling
authors.initials: H
authors.lastname: Xiao
authors.forename: Connie L
authors.initials: CL
authors.lastname: Davis
authors.forename: David
authors.initials: D
authors.lastname: Axelrod
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Abbott
authors.forename: Paolo R
authors.initials: PR
authors.lastname: Salvalaggio
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Burroughs
authors.forename: Georges
authors.initials: G
authors.lastname: Saab
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Brennan
mesh_terms: D000328:Adult; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology*; D007676:Kidney Failure, Chronic / Q000150:complications; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D016016:Proportional Hazards Models; D012306:Risk