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Mid- and Long-Term Health Risks in Living Kidney Donors: A Systematic Review and Meta-analysis

O'Keeffe, Linda M; Ramond, Anna; Oliver-Williams, Clare; Willeit, Peter; Paige, Ellie; Trotter, Patrick; Evans, Jonathan; Wadström, Jonas; Nicholson, Michael; Collett, Dave; Di Angelantonio, Emanuele

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Abstract Background: 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...[Show more]

dc.contributor.authorO'Keeffe, Linda M
dc.contributor.authorRamond, Anna
dc.contributor.authorOliver-Williams, Clare
dc.contributor.authorWilleit, Peter
dc.contributor.authorPaige, Ellie
dc.contributor.authorTrotter, Patrick
dc.contributor.authorEvans, Jonathan
dc.contributor.authorWadström, Jonas
dc.contributor.authorNicholson, Michael
dc.contributor.authorCollett, Dave
dc.contributor.authorDi Angelantonio, Emanuele
dc.date.accessioned2019-07-31T03:19:53Z
dc.identifier.issn0003-4819
dc.identifier.urihttp://hdl.handle.net/1885/164859
dc.description.abstractAbstract Background: 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.description.sponsorshipDr. Di Angelantonio received grant funding from National Health Service Blood and Transplant. The work of the coordinating center was funded by grant WP12-01 from National Health Service Blood and Transplant and grant NIHR BTRU-2014-10024 from the National Institute for Health Research Blood and Transplant Research Unit.
dc.format.mimetypeapplication/pdf
dc.language.isoen_AU
dc.publisherAmerican College of Physicians
dc.rights© 2018
dc.sourceAnnals of Internal Medicine
dc.titleMid- and Long-Term Health Risks in Living Kidney Donors: A Systematic Review and Meta-analysis
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume168
dc.date.issued2018
local.identifier.absfor110312 - Nephrology and Urology
local.identifier.absfor111706 - Epidemiology
local.identifier.absfor111711 - Health Information Systems (incl. Surveillance)
local.identifier.ariespublicationu4492120xPUB204
local.publisher.urlhttps://www.acponline.org/
local.type.statusPublished Version
local.contributor.affiliationO'Keeffe, Linda M , University of Bristol
local.contributor.affiliationRamond , Anna , University of Cambridge
local.contributor.affiliationOliver-Williams , Clare , University of Cambridge
local.contributor.affiliationWilleit, Peter , University of Cambridge
local.contributor.affiliationPaige, Ellie, College of Health and Medicine, ANU
local.contributor.affiliationTrotter , Patrick , National Institute for Health Research Blood and transplant Unit
local.contributor.affiliationEvans , Jonathan , University of Cambridge
local.contributor.affiliationWadström, Jonas , Karolinska University Hospital Stokholm Sweden
local.contributor.affiliationNicholson , Michael , National Institute for Health Research Blood and transplant Research Unit in Organ Donation
local.contributor.affiliationCollett , Dave , National Health Service Blood and Transplant
local.contributor.affiliationDi Angelantonio , Emanuele, University of Cambridge
local.description.embargo2037-12-31
local.bibliographicCitation.issue4
local.bibliographicCitation.startpage276
local.bibliographicCitation.lastpage289
local.identifier.doi10.7326/M17-1235
local.identifier.absseo920204 - Evaluation of Health Outcomes
local.identifier.absseo920106 - Endocrine Organs and Diseases (excl. Diabetes)
dc.date.updated2019-03-31T07:23:47Z
local.identifier.scopusID2-s2.0-85042279046
CollectionsANU Research Publications

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