Living kidney donors are carefully screened, but despite overall good health, long-term donor outcomes have been shown to vary by predonation demographics. Since 2013 the United Network for Organ Sharing has mandated 2 year postdonation follow-up with measurements of kidney function and proteinuria.
Using data from the Scientific Registry of Transplant Recipients, we sought to analyze donor factors associated with the percent change of kidney function from baseline (predonation) to 2 years postdonation, along with incidence of proteinuria reported within the same follow up period.
Older donor age, male gender, black race, and body mass index (BMI) greater than 25 kg/m were independently associated with a greater percent decline in estimated glomerular filtration rate (eGFR). Male gender, black race, and higher BMI were also independently associated with incident proteinuria. In contrast, younger donor age was associated with proteinuria, but proteinuria did not correlate with greater decline in eGFR in the overall cohort.
Donor factors associated with lower eGFR at 2 years postdonation were similar to those previously found to be associated with long-term risk for End Stage Renal Disease (ESRD). Early postdonation assessment of kidney function and proteinuria may help to identify donors who are at greater risk of ESRD and who may benefit from more intense long-term monitoring.