Grupper A, et al. - Researchers compared long term metabolic and renal outcomes between a cohort of 211 living donors vs two control groups: paired-matched controls, and another control group of 2534 healthy individuals with excellent kidney function. A higher estimated Glomerular Filtration Rate (eGFR): (97.6 ± 15.2 vs 96.1 ± 12.2 vs 94.5 ± 12.4 ml/min/1.73m²) was noted among donors on presentation and lower urine albumin to creatinine ratio (UACR) (4.3 ± 5.9 vs 5.9 ± 6.1 vs 6.1 ± 6.9 mg/g) was noted for donors, matched controls and healthy controls, respectively. A mean follow-up of 5.5 years for donors was carried out. After donation, positive eGFR slopes were exhibited by the donors during the first 3 years, followed by negative slopes, whereas the control group presented constantly negative slopes. Being a donor, baseline eGFR, Body Mass Index (BMI) and age but not eGFR on the last day of follow-up or increased delta UACR were variables that were found to be associated with the slope. In addition to the expected mild reduction of GFR and increased urine albumin excretion in donors, an increased risk to develop features of the metabolic syndrome was also observed.