Dataset Information

Risks for donors associated with living kidney donation: meta-analysis.

ABSTRACT:

Background

Living kidney donation risk is likely to differ according to donor's demographics. We aimed to analyse the effects of age, sex, body mass index (BMI) and ethnicity.

Methods

A systematic review and meta-analysis was undertaken of the effects of preoperative patient characteristics on donor kidney function outcomes, surgical complications, and hypertension.

Results

5129 studies were identified, of which 31 met the inclusion criteria, mainly from the USA and Europe. The estimated glomerular filtration rate (eGFR) in donors aged over 60 years was a mean of 9.54 ml per min per 1.73 m2 lower than that of younger donors (P < 0.001). Female donors had higher relative short- and long-term survival. BMI of over 30 kg/m2 was found to significantly lower the donor's eGFR 1 year after donation: the eGFR of obese donors was lower than that of non-obese patients by a mean of -2.70 (95 per cent c.i. -3.24 to -2.15) ml per min per 1.73 m2 (P < 0.001). Obesity was also associated with higher blood pressure both before and 1 year after donation, and a higher level of proteinuria, but had no impact on operative complications. In the long term, African donors were more likely to develop end-stage renal disease than Caucasians.

Conclusion

Obesity and male sex were associated with inferior outcomes. Older donors (aged over 60 years) have a larger eGFR decline than younger donors, and African donors have a higher incidence of ESRD than Caucasians.

SUBMITTER: Bellini MI

PROVIDER: S-EPMC10364766 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

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Publications

Risks for donors associated with living kidney donation: meta-analysis.

Bellini Maria Irene MI Nozdrin Mikhail M Pengel Liset L Knight Simon S Papalois Vassilios V

The British journal of surgery 20220701 8

<h4>Background</h4>Living kidney donation risk is likely to differ according to donor's demographics. We aimed to analyse the effects of age, sex, body mass index (BMI) and ethnicity.<h4>Methods</h4>A systematic review and meta-analysis was undertaken of the effects of preoperative patient characteristics on donor kidney function outcomes, surgical complications, and hypertension.<h4>Results</h4>5129 studies were identified, of which 31 met the inclusion criteria, mainly from the USA and Europe. ...[more]

PMID: 35612960

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Project description:ObjectivesIncreased aortic stiffness measured with carotid-femoral pulse wave velocity (cf-PWV) has been associated with adverse cardiovascular outcomes. Some studies have reported increased cf-PWV in living kidney donors after nephrectomy. This review aimed to determine the effects of living kidney donation on cf-PWV, glomerular filtration rate (GFR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and their differences versus non-nephrectomised healthy individuals.DesignSystematic review and meta-analysis.Data sourcesElectronic databases (MEDLINE, EMBASE, Cochrane Central databases, Cochrane Register of Controlled Trials, Cochrane Methodology Register, Health Technology Database, Technologies in Health, EBM Reviews, ProQuest and 'Grey Matters Light'). Databases were searched from inception to December 2022.Eligibility criteriaWe searched for studies that measured cf-PWV in living kidney donors before and/or after nephrectomy. Non-nephrectomised healthy individuals included as controls were the comparators. Studies that provided age-adjusted cf-PWV reference values in normotensive healthy individuals were also included.Outcome measuresWe evaluated the mean differences in cf-PWV, GFR and BP before-and-after nephrectomy and their mean differences versus non-nephrectomised healthy comparators. We also explored differences in yearly adjusted cf-PWV changes between donors and normotensive healthy individuals.Data extraction/synthesisTwo independent reviewers extracted data and assessed risk of bias (Risk of Bias tool for non-Randomised studies: ROBINS-I) and quality of evidence (GRADE). Pooled effect estimates were calculated using the inverse variance method and analysed with random effect models.ResultsNine interventional (652 donors; 602 controls) and 6 reference studies (6278 individuals) were included. cf-PWV increased at 1-year postdonation (p=0.03) and was on average 0.4 m/s (95% CI 0.07; 0.60) higher than in healthy controls (p=0.01). These differences were non-significant 5 years postnephrectomy (p=0.54). GFR decreased after nephrectomy (p<0.001) and remained reduced compared with healthy controls (p<0.001), but SBP and DBP were not significantly different (p≥0.14). Yearly changes in cf-PWV postnephrectomy were similar to age-adjusted reference values in healthy normotensive individuals (p=0.76).ConclusionsAortic stiffness increases independent of BP 1 year after kidney donation, but the long-term effects seem minimal. These findings may impact future consent of prospective living kidney donors.Prospero registration numberCRD42020185551.

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Dataset Information

Risks for donors associated with living kidney donation: meta-analysis.

Background

Methods

Results

Conclusion

Publications

Risks for donors associated with living kidney donation: meta-analysis.

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