title: A prospective controlled study of living kidney donors: three-year follow-up.
abstract: BACKGROUND
  There have been few prospective controlled studies of kidney donors. Understanding the pathophysiologic effects of kidney donation is important for judging donor safety and improving our understanding of the consequences of reduced kidney function in chronic kidney disease.
  
  
  METHODS
  Prospective, controlled, observational cohort study.
  
  
  METHODS
  3-year follow-up of kidney donors and paired controls suitable for donation at their donor's center.
  
  
  METHODS
  Kidney donation.
  
  
  RESULTS
  Medical history, vital signs, glomerular filtration rate, and other measurements at 6, 12, 24, and 36 months after donation.
  
  
  RESULTS
  At 36 months, 182 of 203 (89.7%) original donors and 173 of 201 (86.1%) original controls continue to participate in follow-up visits. The linear slope of the glomerular filtration rate measured by plasma iohexol clearance declined 0.36±7.55mL/min per year in 194 controls, but increased 1.47±5.02mL/min per year in 198 donors (P=0.005) between 6 and 36 months. Blood pressure was not different between donors and controls at any visit, and at 36 months, all 24-hour ambulatory blood pressure parameters were similar in 126 controls and 135 donors (mean systolic blood pressure, 120.0±11.2 [SD] vs 120.7±9.7mmHg [P=0.6]; mean diastolic blood pressure, 73.4±7.0 vs 74.5±6.5mmHg [P=0.2]). Mean arterial pressure nocturnal dipping was manifest in 11.2% ± 6.6% of controls and 11.3% ± 6.1% of donors (P=0.9). Urinary protein-creatinine and albumin-creatinine ratios were not increased in donors compared with controls. From 6 to 36 months postdonation, serum parathyroid hormone, uric acid, homocysteine, and potassium levels were higher, whereas hemoglobin levels were lower, in donors compared with controls.
  
  
  CONCLUSIONS
  Possible bias resulting from an inability to select controls screened to be as healthy as donors, short follow-up duration, and dropouts.
  
  
  CONCLUSIONS
  Kidney donors manifest several of the findings of mild chronic kidney disease. However, at 36 months after donation, kidney function continues to improve in donors, whereas controls have expected age-related declines in function.
authors: Department of Medicine, Hennepin County Medical Center and University of Minnesota, Minneapolis, MN. Electronic address: bkasiske@cdrg.org.
authors: Bertram L
authors: BL
authors: Kasiske
authors: Department of Medicine, Hennepin County Medical Center and University of Minnesota, Minneapolis, MN.
authors: Teresa
authors: T
authors: Anderson-Haag
authors: Department of Medicine, Hennepin County Medical Center and University of Minnesota, Minneapolis, MN.
authors: Ajay K
authors: AK
authors: Israni
authors: Department of Medicine, University of Iowa, Iowa City, IA.
authors: Roberto S
authors: RS
authors: Kalil
authors: Division of Kidney Urologic and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD.
authors: Paul L
authors: PL
authors: Kimmel
authors: Department of Medicine, Johns Hopkins University, Baltimore, MD.
authors: Edward S
authors: ES
authors: Kraus
authors: Department of Medicine, Mayo Clinic, Rochester, MN.
authors: Rajiv
authors: R
authors: Kumar
authors: Department of Surgery, University of California at San Francisco, San Francisco, CA.
authors: Andrew A
authors: AA
authors: Posselt
authors: Department of Medicine, Ohio State University, Columbus, OH.
authors: Todd E
authors: TE
authors: Pesavento
authors: Department of Medicine, Johns Hopkins University, Baltimore, MD.
authors: Hamid
authors: H
authors: Rabb
authors: Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN.
authors: Michael W
authors: MW
authors: Steffes
authors: Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN.
authors: Jon J
authors: JJ
authors: Snyder
authors: Division of Nephrology, Department of Medicine, University of Maryland, School of Medicine, Baltimore, MD.
authors: Matthew R
authors: MR
authors: Weir
mesh_terms: D000419:Albuminuria / Q000453:epidemiology; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D001806:Blood Urea Nitrogen; D016022:Case-Control Studies; D002940:Circadian Rhythm; D003404:Creatinine / Q000032:analysis; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006710:Homocysteine / Q000097:blood; D006801:Humans; D016030:Kidney Transplantation; D008055:Lipids / Q000097:blood; D019520:Living Donors / Q000706:statistics & numerical data*; D009392:Nephrectomy / Q000009:adverse effects*; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D011446:Prospective Studies; D011507:Proteinuria / Q000453:epidemiology; D014527:Uric Acid / Q000097:blood
chemical_list: D001786:Blood Glucose; D008055:Lipids; D010281:Parathyroid Hormone; D006710:Homocysteine; D014527:Uric Acid; D010758:Phosphorus; D003404:Creatinine
keywords: Assessing Long Term Outcomes in Living Kidney Donors (ALTOLD); Chronic kidney disease (CKD); glomerular filtration rate (GFR); hemoglobin; homocysteine; kidney function; kidney transplantation; living kidney donation; mineral and bone disorders; parathyroid hormone (PTH); patient safety; potassium; renal insufficiency; unilateral nephrectomy; uric acid