Background: Little is known about the long-term outcomes of African American living kidney donors (AALKDs). We undertook this study to describe renal outcomes of AALKDs several years after donation.
Methods: We invited 107 AALKDs to come for follow-up health evaluation.
Results: Thirty-nine subjects (36.4%) completed evaluation at a mean of 7.1+/-1.6 (range, 3.9-10.2) years postdonation. The mean estimated glomerular filtration rate using the abbreviated Modification of Diet in Renal Disease equation [eGFR(MDRD)] at follow-up was 72.1+/-16.3 (range, 42-106) mL/min/1.73 m2, and 18% of subjects had an eGFR(MDRD) of 30 to 59. The mean absolute and relative decrease in eGFR(MDRD) from the time of donation to follow-up was 30.5+/-16.4 mL/min/1.73 m2 and 28.8%, respectively. Subjects whose body mass index was more than or equal to 35 kg/m2 (n=8) were found to have a greater decrement in e(MDRD) than those with body mass index less than 35 kg/m2 (40.1+/-7.3 and 28.3+/-17.1 mL/min/1.73 m2, respectively; P=0.009). Sixteen (41%) were hypertensive at follow-up, as defined as treatment with antihypertensive medications (n=8) or average blood pressure of more than or equal to 140 systolic or 90 mm Hg diastolic (n=10, of whom two were on antihypertensive medications). One subject had macroalbuminuria (>300 microg/mg creatinine), and six (15.4%) had microalbuminuria (30-300 microg/mg creatinine).
Conclusions: AALKDs experience a substantial incidence of hypertension and a modest drop in eGFR(MDRD) postdonation, and obesity may increase the magnitude of renal decline. Further study is urgently needed to determine the long-term risks of AALKDs.