대한신장학회

논문분류	춘계학술대회 초록집
제목	Long term risks for kidney donors: ESRD and mortality
저자	Yaerim Kim1, Mi-yeon Yu1, Chang Wook Jeong2, Hyun Hoe Kim2, Dong Ki Kim1, Kook-Hwan Oh1, Kwon Wook Joo1, Curie Ahn1, Yon Su Kim1, Hajeong Lee1
출판정보	2018; 2018(1):
키워드	end-stage renal disease \| kidney transplantation \| mortality
초록	Objectives: Kidney transplantation has substantial benefits for emotional, social, and family aspects in patient with end-stage renal disease (ESRD). However, there is no medical benefit for kidney donors, and the safety of donors is still not guaranteed. Methods: We collected data of 1,292 LKDs who underwent nephrectomy from 1982 to 2016. We obtained ESRD and mortality data by reviewing medical record, Korean Society of Nephrology ESRD registry, and Statistics Korea using a unique identifier. We compared outcomes of LKDs with those of potentially eligible donors, a total of 42,403 healthy controls (HCs) who underwent health examination from 1995 to 2006. Before comparisons, we excluded HCs with hypertension, diabetes, malignancies, lower eGFR less than 80 ml/min/1.73m2, or advanced age older than 70 years. Mortality was compared with general population using standardized mortality ratio (SMR). Finally, we evaluated impact of LKD on mortality using cox regression analysis. Results: After exclusion, a total of 1,292 LKDs and 24,357 HCs were included. Median follow-up was 8.9 (IQR 4.3-15.2) years in LKDs and 14.8 (IQR 12.5-17.8) years in HCs, respectively. There were only minimal differences in baseline characteristics. Among LKDs, only 2 (0.2%) donors progressed to ESRD, 41 (3.2%) were dead during follow-up. Most common cause of death was malignancy (31.7%). Both HCs (SMR 0.10, 95% CI 0.09-0.10) and LKDs (SMR 0.15, 95% CI 0.11-0.21) revealed excellent mortality ratio compared with age, sex matched general population. In the Kaplan-Meier analysis, LKDs showed similar ESRD progression (P = 0.239) and mortality (P = 0.676), compared with matched HCs. Even after multivariate survival analysis, donor nephrectomy did not affect renal and patient death. Conclusions: In this study, we demonstrated that kidney donors did not increase long-term risk for ESRD and all-cause mortality when compared with matched HCs. An altruistic kidney donation can be considered under cautious post-donation management including cancer screening.
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