title: Long-term risks for kidney donors.
abstract: Previous studies have suggested that living kidney donors maintain long-term renal function and experience no increase in cardiovascular or all-cause mortality. However, most analyses have included control groups less healthy than the living donor population and have had relatively short follow-up periods. Here we compared long-term renal function and cardiovascular and all-cause mortality in living kidney donors compared with a control group of individuals who would have been eligible for donation. All-cause mortality, cardiovascular mortality, and end-stage renal disease (ESRD) was identified in 1901 individuals who donated a kidney during 1963 through 2007 with a median follow-up of 15.1 years. A control group of 32,621 potentially eligible kidney donors was selected, with a median follow-up of 24.9 years. Hazard ratio for all-cause death was significantly increased to 1.30 (95% confidence interval 1.11-1.52) for donors compared with controls. There was a significant corresponding increase in cardiovascular death to 1.40 (1.03-1.91), while the risk of ESRD was greatly and significantly increased to 11.38 (4.37-29.6). The overall incidence of ESRD among donors was 302 cases per million and might have been influenced by hereditary factors. Immunological renal disease was the cause of ESRD in the donors. Thus, kidney donors are at increased long-term risk for ESRD, cardiovascular, and all-cause mortality compared with a control group of non-donors who would have been eligible for donation.
authors.affiliation: Department of Transplant Medicine, Oslo University Hospital, Oslo, Norway.
authors.forename: Geir
authors.initials: G
authors.lastname: Mjøen
authors.affiliation: 1] Department of Nephrology, St Olav University Hospital, Trondheim, Norway [2] Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Stein
authors.initials: S
authors.lastname: Hallan
authors.affiliation: Department of Transplant Medicine, Oslo University Hospital, Oslo, Norway.
authors.forename: Anders
authors.initials: A
authors.lastname: Hartmann
authors.affiliation: Department of Transplant Medicine, Oslo University Hospital, Oslo, Norway.
authors.forename: Aksel
authors.initials: A
authors.lastname: Foss
authors.affiliation: Department of Transplant Medicine, Oslo University Hospital, Oslo, Norway.
authors.forename: Karsten
authors.initials: K
authors.lastname: Midtvedt
authors.affiliation: Department of Transplant Medicine, Oslo University Hospital, Oslo, Norway.
authors.forename: Ole
authors.initials: O
authors.lastname: Øyen
authors.affiliation: Department of Transplant Medicine, Oslo University Hospital, Oslo, Norway.
authors.forename: Anna
authors.initials: A
authors.lastname: Reisæter
authors.affiliation: Department of Transplant Medicine, Oslo University Hospital, Oslo, Norway.
authors.forename: Per
authors.initials: P
authors.lastname: Pfeffer
authors.affiliation: Department of Transplant Medicine, Oslo University Hospital, Oslo, Norway.
authors.forename: Trond
authors.initials: T
authors.lastname: Jenssen
authors.affiliation: Norwegian Renal Registry, Department of Transplant Medicine, Oslo University Hospital, Oslo, Norway.
authors.forename: Torbjørn
authors.initials: T
authors.lastname: Leivestad
authors.affiliation: Department of Transplant Medicine, Oslo University Hospital, Oslo, Norway.
authors.forename: Pål-Dag
authors.initials: PD
authors.lastname: Line
authors.affiliation: Department of Nephrology, St Olav University Hospital, Trondheim, Norway.
authors.forename: Magnus
authors.initials: M
authors.lastname: Øvrehus
authors.affiliation: Department of Transplant Medicine, Oslo University Hospital, Oslo, Norway.
authors.forename: Dag Olav
authors.initials: DO
authors.lastname: Dale
authors.affiliation: Department of Transplant Medicine, Oslo University Hospital, Oslo, Norway.
authors.forename: Hege
authors.initials: H
authors.lastname: Pihlstrøm
authors.affiliation: Department of Preventive Medicine, Oslo University Hospital, Oslo, Norway.
authors.forename: Ingar
authors.initials: I
authors.lastname: Holme
authors.affiliation: Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Friedo W
authors.initials: FW
authors.lastname: Dekker
authors.affiliation: Department of Transplant Medicine, Oslo University Hospital, Oslo, Norway.
authors.forename: Hallvard
authors.initials: H
authors.lastname: Holdaas
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality; D016022:Case-Control Studies; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000401:mortality; D016030:Kidney Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D016016:Proportional Hazards Models; D020858:Tissue and Organ Harvesting / Q000009:adverse effects* / Q000401:mortality