Introduction:
Living Kidney donors (LKD) account for >80% of the donated kidneys in India. Even though largely considered safe, kidney donation is associated with an ESRD rate of 0.5% at 15 years and a lifetime risk of 0.9%. The GFR eligibility criteria for LKDs in India is generally lower (70ml/min), and South Asians have a higher risk of cardiovascular disease (CVD) and earlier onset of Diabetes Mellitus (DM). CV and Kidney outcomes may be different in Indian LKDs; however, there is little data on the long-term outcomes of LKDs in India
Methods:
The transplant coordinator at the Department of Nephrology retrieved data from a prospectively maintained database on LKDs. Demographic and clinical data at the time of donation and clinical data at one, five and 10 years after donation were compiled
Results:
There were 173 LKDs with a follow-up period of 12 years to 2 years. The mean age was 44.56 ± 9.88 Yrs; 79.7% (n=138) were women. Mean BMI before the donation was 25.92 ± 4.99 Kg/m2, 11 (6.3%) were hypertensive, 8 (4.6%) had impaired glucose tolerance, 8 (4.6%) had kidney stones, 6 (3.4%) had hypothyroidism & 2 had CVD (1 rheumatic heart disease, 1 single vessel coronary artery disease). Most (63%) underwent laparoscopic nephrectomy with left kidney nephrectomy in 73%. GFR measured by 99Tc DTPA plasma clearance was 90.61 ± 14.88 ml/min, and the eGFR (CKD-EPI 2021 equation) was 105.08 ± 9.79 ml/min.
The mean eGFR (CKD-EPI 2021 equation) was 100.24 ±10.161 ml/min at 1 year (n=143), 98.91±9.20 ml/min at 5 years (n=102) and 110.22 ± 11.63 ml/min at 10 years (n=32). Within 5 years of donation, 7 (4%) developed new-onset HT, 10 (5.78%) developed DM or new onset IGT, 3 developed significant proteinuria, 5 (2.89%) developed cancer and 3 developed AKI (recovered). Six LKDs had 8 successful full-term uncomplicated pregnancies after donation
Conclusions:
Even though eGFR appears well-preserved 5 years after kidney donation, new onset HT, DM, Proteinuria and AKI were found in many LKDs. Very stringent criteria while selecting LKDs and regular long-term follow-up after donation may be essential
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.