Donación renal: criterios de aceptación y su influencia a los 5 y 10 años post donación

Introduction

Acceptance criteria for kidney donors (KDs) have become more flexible over time, raising questions about their long-term consequences. The objective of this study was to evaluate changes in the baseline characteristics of accepted KDs and to analyze their evolution after donation.

Methods

A cohort study was conducted that included all KDs from our institution from 2010 to 2017. Baseline characteristics were compared by period and follow-up was carried out up to 10 years after donation.

Results

169 KDs aged 45.6 ± 12.2 years were included, mostly women (63.9%). The main comorbidity they presented was obesity (29.6%) and controlled arterial hypertension (10.7%). KDs showed significant differences in estimated glomerular filtration rate (eGFR) with lower values in the last study period (P = .002). Progression to chronic kidney disease (CKD) III-a was 31% (95% CI: 23.5-39.6) and III-b 3.9% (95% CI: 0.5-7.2). Related risk factors were age (HRa = 1.04; 95% CI: 1.01-1,07; P = .033) and pre-donation eGFR (HRa = 0,97; 95% CI: 0.95-0,99; P = .028). No patient progressed to CKD IV, V or died during follow-up.

Conclusion

There were subtle changes in the characteristics of the accepted KR. Age and baseline eGFR were independent predictors of progression to CKD III post-donation. The incidence of advanced CKD and mortality were null at 10 years of post-donation follow-up, so it seems to be a safe procedure in our environment in the long term.