LONG-TERM FOLLOW-UP OF KIDNEY DONORS - A LONGITUDINAL-STUDY

Background. Kidney donors are not adversely affected by compensatory h yperfiltration of the remaining kidney in the early years after nephre ctomy, but longterm longitudinal studies are lacking. Methods. The ren al function and blood pressure of 75 donors was evaluated in 1984, 1.4 -20.7 years after surgery. Forty-seven of the original cohort (23 male , age 38-80 years) underwent repeat study a decade later (12-31 years post-nephrectomy), using identical laboratory techniques. Results. Glo merular filtration rates (GFR) as measured by Cr-51 EDTA clearance was relatively unchanged a decade later with 41 of 47 subjects (87%) havi ng EDTA clearance within the normal laboratory reference range at revi ew. The change in GFR in the remaining six subjects was statistically not significant. No correlation between GFR and time after nephrectomy was detected. Albumin excretion rate (AER), on timed overnight urine collections, was increased (> 20 mu g/min) in 16 subjects (34%), altho ugh 14 of these individuals were also hypertensive. The prevalence of hypertension was significantly increased compared with age/sex matched data from epidemiological studies of the general population (both in the UK and the US), especially in those over the age of 55 years. Conc lusion. This study demonstrates that the function of the solitary kidn ey is not adversely affected by prolonged compensatory hyperfiltration , although there appears to be an increased prevalence of microalbumin uria and hypertension. Regular follow-up of kidney donors is recommend ed in order to manage their complications effectively and to detect hy pertension and or renal impairment early in those who may develop it.