title: Single-centre long-term follow-up of live kidney donors demonstrates preserved kidney function but the necessity of a structured lifelong follow-up.
abstract: BACKGROUND
  The increase of live kidney donation (LKD) demands that we scrutinize its long-term consequences. Socialized medicine in Sweden has allowed us to survey long-term consequences of LKD with a high response rate.
  
  
  METHODS
  Between 1974 and 2008, 455 LKDs were performed; 28 donors were deceased and 14 had moved abroad at the time of the survey. Of the remaining 413, 96% agreed to participate in a retrospective study with laboratory testing and answering a questionnaire.
  
  
  RESULTS
  Mean age at donation was 49 ± 10 years, and the mean time since nephrectomy was 11 ± 7 years (range 1-33). No death was of renal cause. S-creatinine at follow-up was 93 ± 18 μmol/L, 28% had treated hypertension, of whom only 52% had BP <140/90. Eleven per cent had spot microalbuminuria, and 1% were diagnosed with diabetes mellitus. Seventy-one per cent had check-ups at least every second year, but 14% had no check-ups. Eighty per cent would be willing to donate again if it were possible, and only 3% regretted the donation.
  
  
  CONCLUSIONS
  Renal function is well preserved in the long term after donation, no case of end-stage renal disease was identified, and a large majority of our donors would donate again if it were possible. Although rates of microalbuminuria and hypertension were at expected levels, a significant number of donors demonstrated elevated blood pressure levels and inadequate antihypertensive treatment. A relatively large number of donors did not receive regular check-ups. Both of these issues demonstrate the need for a better-structured lifelong follow-up.
authors.affiliation: Department of Surgical Sciences, Uppsala University , Uppsala , Sweden.
authors.forename: Bengt
authors.initials: B
authors.lastname: von Zur-Mühlen
authors.forename: David
authors.initials: D
authors.lastname: Berglund
authors.forename: Shinji
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Jonas
authors.initials: J
authors.lastname: Wadström
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged
keywords: Follow-up; kidney; live; live donors; long-term