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dc.contributor.authorO'Keeffe, Linda M
dc.contributor.authorRamond, Anna
dc.contributor.authorDi Angelantonio, Emanuele
dc.date.accessioned2018-11-17T00:30:57Z
dc.date.available2018-11-17T00:30:57Z
dc.date.issued2018-08-21
dc.identifier.issn0003-4819
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/285350
dc.description.abstractBACKGROUND: Long-term health risks for adults who donate kidneys are unclear. PURPOSE: To summarize evidence about mid- and long-term health risks associated with living kidney donation in adults. DATA SOURCES: PubMed, Embase, Scopus, and PsycINFO without language restriction from April 1964 to July 2017. STUDY SELECTION: Observational studies with at least 1 year of follow-up that compared health outcomes in adult living kidney donors versus nondonor populations. DATA EXTRACTION: Two investigators independently extracted study data and assessed study quality. DATA SYNTHESIS: 52 studies, comprising 118 426 living kidney donors and 117 656 nondonors, were included. Average follow-up was 1 to 24 years. No evidence suggested higher risk for all-cause mortality, cardiovascular disease, hypertension, type 2 diabetes, or adverse psychosocial health outcomes in living kidney donors than in nondonor populations. Donors had higher diastolic blood pressure, lower estimated glomerular filtration rates, and higher risk for end-stage renal disease (ESRD) (relative risk [RR], 8.83 [95% CI, 1.02 to 20.93]) and preeclampsia in female donors (RR, 2.12 [CI, 1.06 to 4.27]). Despite the increased RR, donors had low absolute risk for ESRD (incidence rate, 0.5 event [CI, 0.1 to 4.9 events] per 1000 person-years) and preeclampsia (incidence rate, 5.9 events [CI, 2.9 to 8.9 events] per 100 pregnancies). LIMITATION: Generalizability was limited by selected control populations, few studies reported pregnancy-related outcomes, and few studies were from low- and middle-income countries. CONCLUSION: Although living kidney donation is associated with higher RRs for ESRD and preeclampsia, the absolute risk for these outcomes remains low. Compared with nondonor populations, living kidney donors have no increased risk for other major chronic diseases, such as type 2 diabetes, or for adverse psychosocial outcomes. PRIMARY FUNDING SOURCE: National Health Service Blood and Transplant and National Institute for Health Research. (PROSPERO: CRD42017072284).
dc.format.mediumPrint
dc.languageeng
dc.publisherAmerican College of Physicians
dc.subjectKidney
dc.subjectHumans
dc.subjectKidney Transplantation
dc.subjectLiving Donors
dc.titleMid- and Long-Term Health Risks in Living Kidney Donors.
dc.typeArticle
prism.endingPage266
prism.issueIdentifier4
prism.publicationDate2018
prism.publicationNameAnn Intern Med
prism.startingPage265
prism.volume169
dc.identifier.doi10.17863/CAM.32718
dcterms.dateAccepted2017-11-13
rioxxterms.versionofrecord10.7326/L18-0341
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2018-08
dc.contributor.orcidRamond, Anna [0000-0002-9958-3693]
dc.contributor.orcidDi Angelantonio, Emanuele [0000-0001-8776-6719]
dc.identifier.eissn1539-3704
rioxxterms.typeJournal Article/Review
pubs.funder-project-idNHS Blood and Transplant (NHSBT) (WP12-01)
pubs.funder-project-idMedical Research Council (MR/L003120/1)
pubs.funder-project-idBritish Heart Foundation (None)
rioxxterms.freetoread.startdate2019-08-31


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