title: Reassessing medical risk in living kidney donors.
abstract: The short- and long-term effects of unilateral nephrectomy on living donors have been important considerations for 60 years. Short-term risk is well established (0.03% mortality and <1% risk of major morbidity), but characterization of long-term risk is evolving. Relative to the general population, risk of mortality, ESRD, hypertension, proteinuria, and cardiovascular disease is comparable or lower. However, new studies comparing previous donors with equally healthy controls indicate increased risk of metabolic derangements (particularly involving calcium homeostasis), renal failure, and possibly, mortality. We discuss how these results should be interpreted and their influence on the practice of living donor kidney transplantation.
authors.affiliation: Division of Nephrology and Comprehensive Transplant Institute, University of Alabama at Birmingham, Birmingham, Alabama; and rgaston@uab.edu.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Gaston
authors.affiliation: Division of Nephrology and Comprehensive Transplant Institute, University of Alabama at Birmingham, Birmingham, Alabama; and.
authors.forename: Vineeta
authors.initials: V
authors.lastname: Kumar
authors.affiliation: Department of Surgery, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Matas
mesh_terms: D006801:Humans; D016030:Kidney Transplantation; D019520:Living Donors; D009392:Nephrectomy / Q000009:adverse effects*; D018570:Risk Assessment
keywords: ESRD; kidney transplantation; living donor; mortality risk