title: A prospective controlled study of kidney donors: baseline and 6-month follow-up.
abstract: BACKGROUND
  Most previous studies of living kidney donors have been retrospective and have lacked suitable healthy controls. Needed are prospective controlled studies to better understand the effects of a mild reduction in kidney function from kidney donation in otherwise healthy individuals.
  
  
  METHODS
  Prospective, controlled, observational cohort study.
  
  
  METHODS
  Consecutive patients approved for donation at 8 transplant centers in the United States were asked to participate. For every donor enrolled, an equally healthy control with 2 kidneys who theoretically would have been suitable to donate a kidney also was enrolled.
  
  
  METHODS
  Kidney donation.
  
  
  METHODS
  At baseline predonation and at 6 months after donation, medical history, vital signs, measured (iohexol) glomerular filtration rate, and other measurements were collected. There were 201 donors and 198 controls who completed both baseline and 6-month visits and form the basis of this report.
  
  
  RESULTS
  Compared with controls, donors had 28% lower glomerular filtration rates at 6 months (94.6 ± 15.1 [SD] vs 67.6 ± 10.1 mL/min/1.73 m(2); P < 0.001), associated with 23% greater parathyroid hormone (42.8 ± 15.6 vs 52.7 ± 20.9 pg/mL; P < 0.001), 5.4% lower serum phosphate (3.5 ± 0.5 vs 3.3 ± 0.5 mg/dL; P < 0.001), 3.7% lower hemoglobin (13.6 ± 1.4 vs 13.1 ± 1.2 g/dL; P < 0.001), 8.2% greater uric acid (4.9 ± 1.2 vs 5.3 ± 1.1 mg/dL; P < 0.001), 24% greater homocysteine (1.2 ± 0.3 vs 1.5 ± 0.4 mg/L; P < 0.001), and 1.5% lower high-density lipoprotein cholesterol (54.9 ± 16.4 vs 54.1 ± 13.9 mg/dL; P = 0.03) levels. There were no differences in albumin-creatinine ratios (5.0 [IQR, 4.0-6.6] vs 5.0 [IQR, 3.3-5.4] mg/g; P = 0.5), office blood pressures, or glucose homeostasis.
  
  
  CONCLUSIONS
  Short duration of follow-up and possible bias resulting from an inability to screen controls with kidney and vascular imaging performed in donors.
  
  
  CONCLUSIONS
  Kidney donors have some, but not all, abnormalities typically associated with mild chronic kidney disease 6 months after donation. Additional follow-up is warranted.
authors.affiliation: Department of Medicine, Hennepin County Medical Center, Minneapolis, MN 55415, USA. kasis001@umn.edu
authors.forename: Bertram L
authors.initials: BL
authors.lastname: Kasiske
authors.forename: Teresa
authors.initials: T
authors.lastname: Anderson-Haag
authors.forename: Hassan N
authors.initials: HN
authors.lastname: Ibrahim
authors.forename: Todd E
authors.initials: TE
authors.lastname: Pesavento
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Weir
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Nogueira
authors.forename: Fernando G
authors.initials: FG
authors.lastname: Cosio
authors.forename: Edward S
authors.initials: ES
authors.lastname: Kraus
authors.forename: Hamid H
authors.initials: HH
authors.lastname: Rabb
authors.forename: Roberto S
authors.initials: RS
authors.lastname: Kalil
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Posselt
authors.forename: Paul L
authors.initials: PL
authors.lastname: Kimmel
authors.forename: Michael W
authors.initials: MW
authors.lastname: Steffes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007258:Informed Consent; D016030:Kidney Transplantation / Q000502:physiology* / Q000639:trends*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery*; D055815:Young Adult
keywords: Chronic kidney disease; glomerular filtration rate; mineral and bone disorders; patient safety; unilateral nephrectomy