O'Keeffe LM, et al. - This systematic review was performed to summarize evidence about mid- and long-term health risks associated with living kidney donation in adults. For end-stage renal disease (ESRD) and preeclampsia, living kidney donation was correlated with higher relative risks (RRs). However, the absolute risk for these outcomes remained low. Living kidney donors had no increased risk for other major chronic diseases, such as type 2 diabetes, or for adverse psychosocial outcomes, compared with nondonor populations.

Methods

• Between April 1964 to July 2017, the researchers searched PubMed, Embase, Scopus, and PsycINFO without language restriction.
• They included observational studies with at least 1 year of follow-up that compared health outcomes in adult living kidney donors vs nondonor populations.
• For this study, 2 investigators independently extracted study data and evaluated study quality.

Results

• The researchers included 52 studies (comprising 118,426 living kidney donors and 117,656 nondonors).
• In this study, average follow-up was 1 to 24 years.
• Living kidney donors, compared to nondonor populations, showed no higher risk for all-cause mortality, cardiovascular disease, hypertension, type 2 diabetes, or adverse psychosocial health outcomes.
• Donors were found to have 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]).
• 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), despite the increased RR.