Follow-up of 91 living-related renal allograft donors

Abstract

The long-term risks of uninephrectomy in the living-related kidney donors are of concern. We studied the outcome in living-related allograft donors after donation who have been followed up at Princess Margaret Hospital from 1980 to 1996 by comparing renal function, blood pressure and proteinuria. Ninety-one allograft donors, aged from 19 to 59 years (mean 36.61 ±7.63 years; 43 males and 48 females) were followed up for 1 to 17 years (mean 5.5 ±2.5 years). After nephrectomy, serum creatinine rose by 46.2% from baseline 81.3 ±13.0 μmol/L to 118.9 ±32.9 μmol/L at 3 months (p < 0.001). In 58 of the 91 patients who were followed up for more than 3 years, serum creatinine decreased to 99.7 ±13.2 μmol/L (p < 0.05) at the end of the study period as compared with serum creatinine at 3-month follow-up. Creatinine clearance also decreased from 107.6 ±24.0 ml/min before nephrectomy to 78.8 ±15.7 ml/min at 1-year follow-up (p < 0.001). Then it became 79.8 ±18.3 ml/min at the latest follow-up (p = 0.599). Systolic blood pressure increased from 114.2 ±8.6 mmHg before nephrectomy to 120.0 ±10.4 mmHg (p < 0.001) at the latest follow-up after nephrectomy. Meanwhile, the diastolic blood pressure rose from 71.1 ±7.2 mmHg at baseline to 73.1 ±8.3 mmHg at the end of the study period (p = 0.091). The mean arterial blood pressure increased from 85.5 ±7.0 mmHg to 88.7 ±8.1 mmHg at the latest follow-up (p > 0.005). Proteinuria increased from 65 ±55 mg/day to 96 ±55 mg/day at the latest follow-up (p = 0.142). In conclusion, there was no progression of renal dysfunction in renal allograft donor after nephrectomy. Serum creatinine even improved significantly at the end of the study period as compared with that at 3-month postnephrectomy. Systolic blood pressure and mean arterial blood pressure had a small increment at the latest follow-up. The prevalence of hypertension was 4.4%. Moreover, proteinuria did not show a significant increase after donation.