title: Risk of serious gastrointestinal bleeding in living kidney donors.
abstract: Individuals with moderate-to-severe reduced renal function have greater risk of gastrointestinal bleeding than those with normal renal function. We conducted a retrospective matched cohort study to assess whether living kidney donors share a similar risk. We reviewed pre-donation charts for living kidney donations from 1992 to 2009 in Ontario, Canada, and linked this information to healthcare databases. We selected healthy non-donors from the general population and matched ten non-donors to every donor. Of the 2009 donors and 20,090 matched non-donors, none had evidence of gastrointestinal bleeding prior to cohort entry. The cohort was followed for a median of 8.4 yr (maximum 19.7 yr; loss to follow-up <7%). There was no significant difference in the rate of hospitalization with gastrointestinal bleeding in donors compared to non-donors (18.5 vs. 14.9 events per 10,000 person-years; rate ratio 1.24; 95% confidence interval [CI] 0.85-1.81). Similar results were obtained when we assessed the time to first hospitalization with gastrointestinal bleeding (hazard ratio 1.25, 95% CI 0.87-1.79). In conclusion, we found living kidney donation was not associated with a higher risk of hospitalization with gastrointestinal bleeding. These results are reassuring for the safety of the practice.
authors.affiliation: Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada; Division of Nephrology, Department of Medicine, Western University, London, ON, Canada.
authors.forename: Sonia M
authors.initials: SM
authors.lastname: Thomas
authors.forename: Ngan N
authors.initials: NN
authors.lastname: Lam
authors.forename: Anjie
authors.initials: A
authors.lastname: Huang
authors.forename: Danielle M
authors.initials: DM
authors.lastname: Nash
authors.forename: G V
authors.initials: GV
authors.lastname: Prasad
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Knoll
authors.forename: John J
authors.initials: JJ
authors.lastname: Koval
authors.forename: Krista L
authors.initials: KL
authors.lastname: Lentine
authors.forename: S Joseph
authors.initials: SJ
authors.lastname: Kim
authors.forename: Ahsan
authors.initials: A
authors.lastname: Alam
authors.forename: Charmaine E
authors.initials: CE
authors.lastname: Lok
authors.forename: Darin J
authors.initials: DJ
authors.lastname: Treleaven
authors.forename: Amit X
authors.initials: AX
authors.lastname: Garg
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D020858:Tissue and Organ Harvesting
keywords: cohort study; gastrointestinal bleeding; health administrative data; living kidney donor; transplantation