Impact of cardiovascular risk factors on glomerular filtration rate and on morbidity and mortality after renal donation

Abstract

Background and objectives

Living donor kidney transplantation increases recipient and graft survival compared with cadaveric donor transplantation. Correct donor selection is essential to optimize transplant outcomes as well as post-donation safety. The aim of this study is to analyze the influence of baseline characteristics of living kidney donors on renal function, morbidity and mortality after nephrectomy.

Patients and methods

An observational, descriptive, cross-sectional study was designed that included living kidney donors followed up at the Salamanca University Hospital between 2011 and January 2023. Statistical significance was considered if P ≤ .05.

Results

Ninety-one donors were included, 63% women, with a mean age of 52 ± 10.8 years. 52.1% were overweight or obese, 9.9% had hypertension and 22% were dyslipidemic. Mortality was 0% and 84.3% had no complications. GFR (CKD-EPI) dropped from 92 to 57.1 ml/min/1.73 m² at 1 month after nephrectomy. There was a significant increase in proteinuria at 1 month and 2 years. After nephrectomy, BMI, MAP, HbA1c, uric acid, total cholesterol, LDL and triglycerides increased (P ≤ .05).

Conclusions

The mean GFR of donors as well as its compensation after nephrectomy was lower and slower than the figures reported in the literature, probably due to the higher mean age of our donors. The increased prevalence of obesity, dyslipidemia and hyperuricemia postdonation and worsening of HbA1c and MAP levels make strict monitoring of donors necessary. In our experience, kidney donation is a safe process with low morbidity and mortality.