Nephrology Dialysis Transplantation, Vol 12, Issue 8 1615-1621, Copyright © 1997 by Oxford University Press
R Saran, S Marshall, R Madsen, P Keavey and J Tapson
Background: Kidney donors are not adversely affected
by compensatory hyperfiltration of the remaining kidney in the early years
after nephrectomy, but long-term longitudinal studies are lacking.
Method: The renal function and blood pressure of 75
donors was evaluated in 1984, 1.4-20.7 years after surgery. Forty-seven of
the original cohort (23 male, age 38-80 years) underwent repeat study a
decade later (12-31 years post-nephrectomy), using identical laboratory
techniques. Results: Glomerular filtration rates (GFR)
as measured by 51Cr EDTA clearance was relatively
unchanged a decade later with 41 of 47 subjects (87%) having EDTA clearance
within the normal laboratory reference range at review. The change in GFR
in the remaining six subjects was statistically not significant. No
correlation between GFR and time after nephrectomy was detected. Albumin
excretion rate (AER), on timed overnight urine collections, was increased
(>20 &mgr;/min) in 16 subjects (34%), although 14 of these
individuals were also hypertensive. The prevalence of hypertension was
significantly increased compared with age/sex matched data from
epidemiological studies of the general population (both in the UK and the
US), especially in those over the age of 55 years.
Conclusion: This study demonstrates that the function
of the solitary kidney is not adversely affected by prolonged compensatory
hyperfiltration, although there appears to be an increased prevalence of
microalbuminuria and hypertension. Regular follow-up of kidney donors is
recommended in order to manage their complications effectively and to
detect hypertension and or renal impairment early in those who may develop
it. Keywords: kidney donors; blood pressure;
glomerular filtration rate; creatinine clearance; microalbuminuria
ORIGINAL ARTICLES
Long-term follow-up of kidney donors: a longitudinal study
University of Missouri, Columbia MO, USA; University of Newcastle upon Tyne, UK; Regional Medical Physics Department, Freeman Hospital, Newcastle upon Tyne, UK; Corresponding author at: Division of Nephrology, Department of Internal Medicine, University of Missouri, MA436 Health Sciences Center, Columbia, MO 65212, USA
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