scholarly journals Identifying Outcomes that Are Important to Living Kidney Donors

2018 ◽  
Vol 13 (6) ◽  
pp. 916-926 ◽  
Author(s):  
Camilla S. Hanson ◽  
Jeremy R. Chapman ◽  
John S. Gill ◽  
John Kanellis ◽  
Germaine Wong ◽  
...  
Keyword(s):  
Kidney Function ◽  
Kidney Failure ◽  
Regional Differences ◽  
Nominal Group Technique ◽  
Nominal Group ◽  
Psychosocial Effects ◽  
Living Kidney Donor ◽  
Kidney Donors ◽  
Living Kidney Donors ◽  
Kidney Health

Background and objectivesLiving kidney donor candidates accept a range of risks and benefits when they decide to proceed with nephrectomy. Informed consent around this decision assumes they receive reliable data about outcomes they regard as critical to their decision making. We identified the outcomes most important to living kidney donors and described the reasons for their choices.Design, setting, participants, & measurementsPrevious donors were purposively sampled from three transplant units in Australia (Sydney and Melbourne) and Canada (Vancouver). In focus groups using the nominal group technique, participants identified outcomes of donation, ranked them in order of importance, and discussed the reasons for their preferences. An importance score was calculated for each outcome. Qualitative data were analyzed thematically.ResultsAcross 14 groups, 123 donors aged 27–78 years identified 35 outcomes. Across all participants, the ten highest ranked outcomes were kidney function (importance=0.40, scale 0–1), time to recovery (0.27), surgical complications (0.24), effect on family (0.22), donor-recipient relationship (0.21), life satisfaction (0.18), lifestyle restrictions (0.18), kidney failure (0.14), mortality (0.13), and acute pain/discomfort (0.12). Kidney function and kidney failure were more important to Canadian participants, compared with Australian donors. The themes identified included worthwhile sacrifice, insignificance of risks and harms, confidence and empowerment, unfulfilled expectations, and heightened susceptibility.ConclusionsLiving kidney donors prioritized a range of outcomes, with the most important being kidney health and the surgical, lifestyle, functional, and psychosocial effects of donation. Donors also valued improvements to their family life and donor-recipient relationship. There were clear regional differences in the rankings.

scholarly journals Has the UK living kidney donor population changed over time? A cross-sectional descriptive analysis of the UK living donor registry between 2006 and 2017

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e033906
Author(s):  
Phillippa K Bailey ◽  
Katie Wong ◽  
Matthew Robb ◽  
Lisa Burnapp ◽  
Alistair Rogers ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Kidney Failure ◽  
Living Donor ◽  
Kidney Donor ◽  
Living Kidney Donor ◽  
Cross Sectional ◽  
Kidney Donors ◽  
Living Kidney Donors ◽  
The Uk ◽  
Over Time

BackgroundA living-donor kidney transplant is the best treatment for most people with kidney failure. Population cohort studies have shown that lifetime living kidney donor risk is modified by sex, age, ethnicity, body mass index (BMI), comorbidity and relationship to the recipient.ObjectivesWe investigated whether the UK population of living kidney donors has changed over time, investigating changes in donor demographics.DesignWe undertook a cross-sectional analysis of the UK living kidney donor registry between January 2006 to December 2017. Data were available on living donor sex, age, ethnicity, BMI, hypertension and relationship to recipient.SettingUK living donor registry.Participants11 651 consecutive living kidney donors from January 2006 to December 2017.Outcome measuresLiving kidney donor demographic characteristics (sex, age, ethnicity, BMI and relationship to the transplant recipient) were compared across years of donation activity. Donor characteristics were also compared across different ethnic groups.ResultsOver the study period, the mean age of donors increased (from 45.8 to 48.7 years, p<0.001), but this change appears to have been limited to the White population of donors. Black donors were younger than White donors, and a greater proportion were siblings of their intended recipient and male. The proportion of non-genetically related non-partner donations increased over the 12-year period of analysis (p value for linear trend=0.002).ConclusionsThe increasing age of white living kidney donors in the UK has implications for recipient and donor outcomes. Despite an increase in the number of black, Asian and minority ethnic individuals waitlisted for a kidney transplant, there has been no increase in the ethnic diversity of UK living kidney donors. Black donors in the UK may be at a much greater risk of developing kidney failure due to accumulated risks: whether these risks are being communicated needs to be investigated.

Quantification of Single-Kidney Function and Volume in Living Kidney Donors Using Dynamic Contrast-Enhanced MRI

2016 ◽  
Vol 207 (5) ◽  
pp. 1022-1030 ◽  
Author(s):  
Eli Eikefjord ◽  
Erling Andersen ◽  
Erlend Hodneland ◽  
Einar Svarstad ◽  
Arvid Lundervold ◽  
...  
Keyword(s):  
Kidney Function ◽  
Kidney Donors ◽  
Living Kidney Donors ◽  
Dynamic Contrast Enhanced Mri ◽  
Dynamic Contrast Enhanced ◽  
Enhanced Mri ◽  
Contrast Enhanced ◽  
Single Kidney ◽  
Contrast Enhanced Mri

scholarly journals Reduced kidney function in living kidney donors

2007 ◽  
Vol 71 (10) ◽  
pp. 1077 ◽  
Author(s):  
R.K. Wan ◽  
E. Spalding ◽  
D. Winch ◽  
K. Brown ◽  
C.C. Geddes
Keyword(s):  
Kidney Function ◽  
Kidney Donors ◽  
Living Kidney Donors ◽  
Reduced Kidney Function

Prediabetic Living Kidney Donors Have Preserved Kidney Function at 10 Years After Donation

2014 ◽  
Vol 97 (7) ◽  
pp. 748-754 ◽  
Author(s):  
Sindhu Chandran ◽  
Umesh Masharani ◽  
Allison B. Webber ◽  
David M. Wojciechowski
Keyword(s):  
Kidney Function ◽  
Kidney Donors ◽  
Living Kidney Donors

scholarly journals Application of the 2017 KDIGO Guideline for the Evaluation and Care of Living Kidney Donors to Clinical Practice

2020 ◽  
Vol 15 (6) ◽  
pp. 896-905 ◽  
Author(s):  
Amit X. Garg ◽  
Andrew S. Levey ◽  
Bertram L. Kasiske ◽  
Michael Cheung ◽  
Krista L. Lentine ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Work Group ◽  
Original Data ◽  
Professional Organizations ◽  
Living Kidney Donor ◽  
Projection Model ◽  
Kidney Donors ◽  
Living Kidney Donors ◽  
Donor Evaluation ◽  
Risk Projection

The Kidney Disease: Improving Global Outcomes (KDIGO) 2017 “Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors” was developed to assist medical professionals who evaluate living kidney donor candidates and provide care before, during, and after donation. This guideline Work Group concluded that a comprehensive approach to donor candidate risk assessment should replace eligibility decisions on the basis of assessments of single risk factors in isolation. To address all issues important to living donors in a pragmatic and comprehensive guideline, many of the guideline recommendations were on the basis of expert consensus opinion even when no direct evidence was available. To advance available evidence, original data analyses were also undertaken to produce a “proof-of-concept” risk projection model for kidney failure. This was done to illustrate how the community can advance a new quantitative framework of risk that considers each candidate’s profile of demographic and health characteristics. A public review by stakeholders and subject matter experts as well as industry and professional organizations informed the final formulation of the guideline. This review highlights the guideline framework, key concepts, and recommendations, and uses five patient scenarios and 12 guideline statements to illustrate how the guideline can be applied to support living donor evaluation and care in clinical practice.

Comparison of Postdonation Kidney Function Between Caucasian Donors and Low-risk APOL1 Genotype Living Kidney Donors of African Ancestry

2018 ◽  
Vol 102 (11) ◽  
pp. e462-e463 ◽  
Author(s):  
François Gaillard ◽  
Olivier Gribouval ◽  
Marie Courbebaisse ◽  
Catherine Fournier ◽  
Corinne Antignac ◽  
...  
Keyword(s):  
Kidney Function ◽  
African Ancestry ◽  
Low Risk ◽  
Kidney Donors ◽  
Living Kidney Donors

P1718COMPARISON OF MEASURED GLOMERULAR FILTRATION RATE USING 24-HOUR URINE CREATININE CLEARANCE WITH 51-CHROMIUM EDTA IN A MALAYSIAN COHORT OF LIVING KIDNEY DONOR CANDIDATES

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Chee Keong Thye ◽  
Yee Wan Lee ◽  
Maisarah Jalalonmuhali ◽  
Soo Kun Lim ◽  
Kok Peng Ng
Keyword(s):  
Glomerular Filtration Rate ◽  
Creatinine Clearance ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Urine Volume ◽  
Kidney Donor ◽  
Living Kidney Donor ◽  
Kidney Donors ◽  
Living Kidney Donors ◽  
51Cr Edta

Abstract Background and Aims All living kidney donors undergo assessment of renal function by evaluation of Glomerular Filtration Rate (GFR). 51Cr-EDTA is one of the most widely used marker for measuring GFR but it is hampered by cost and laboriousness as well as not being widely available in Malaysia. Measuring 24-hour urine for creatinine clearance (Ccr) is a common alternative when exogenous filtration markers are not available. Ccr suffers from over/underestimation of measured GFR (mGFR) due to errors in urine collection and tubular secretion of creatinine. This is a study to compare the correlation of Ccr against 51Cr-EDTA in measuring GFR among the living donors in Malaysian population. Method This is a cross-sectional, single-centre study of a cohort of living kidney donor candidates from January 2007 to March 2019. All candidates who had mGFR done with both 51Cr-EDTA and Ccr in University Malaya Medical Centre were enrolled. Special consideration was taken to account for adequate urine sampling for Ccr. Clinical data was analysed for correlation, bias, precision and accuracy between Ccr and 51Cr-EDTA. Results A total of 83 living kidney donors with a mean age of 45.60 ± 11.06 years and body mass index (BMI) of 24.36 ± 4.03 were enrolled. Female comprised 74.7% of the donors while Chinese, Malay and Indian accounted for 67.5%, 20.5% and 7.2% of the donors respectively. The study group had a mean serum creatinine of 63.37 ± 16.00 umol/L with a urine volume of 2.03 ± 0.81 L (range 0.70 – 3.82). mGFR from 51Cr-EDTA was 125.56 ± 27.64 ml/min/1.73m2 (range 77.0 – 194.3) whereas calculated Ccr was 136.05 ± 36.15 ml/min/1.73m2 (range 75.32 – 280.06). The correlation coefficient between Ccr and 51Cr-EDTA is moderate (r = 0.43) (p &lt; 0.01). Mean absolute bias between Ccr and 51Cr-EDTA was 10.59 ± 37.99 ml/min/1.73m2 (p &lt; 0.05). The accuracy of Ccr within 30% of 51Cr-EDTA was 77.11%. Conclusion Our study showed that Ccr significantly overestimates mGFR compared to 51Cr-EDTA. However, there is a significantly moderate positive correlation between Ccr and 51Cr-EDTA. Thus, in the absence of 51Cr-EDTA, Ccr is a clinically acceptable alternative if utilized with care and understanding its limitations.

Efficacy of Follow-up Care System of Living Kidney Donors in Monitoring of Residual Kidney Function

2018 ◽  
Vol 50 (6) ◽  
pp. 1590-1596
Author(s):  
M. Kwapisz ◽  
R. Kieszek ◽  
K. Jędrzejko ◽  
M. Bieniasz ◽  
J. Gozdowska ◽  
...  
Keyword(s):  
Kidney Function ◽  
Kidney Donors ◽  
Living Kidney Donors ◽  
Residual Kidney Function ◽  
Follow Up Care ◽  
Care System

scholarly journals Physician Attitudes Toward Living Kidney Donation

2018 ◽  
Vol 29 (1) ◽  
pp. 78-83 ◽  
Author(s):  
Howard Trachtman ◽  
Brendan Parent ◽  
Ari Kirshenbaum ◽  
Arthur Caplan
Keyword(s):  
Internal Medicine ◽  
Careful Consideration ◽  
Physician Attitudes ◽  
Kidney Donation ◽  
Living Donation ◽  
Living Kidney Donation ◽  
Kidney Donor ◽  
Living Kidney Donor ◽  
Kidney Donors ◽  
Living Kidney Donors

Background: Compared to dialysis, living kidney donation has a greater chance of restoring health and is associated with better outcomes than deceased kidney donation. Although physicians advocate for this treatment, it is uncertain how they would act as potential living kidney donors or recipients. Methods: We surveyed 104 physicians, pediatric, and internal medicine nephrologists, to ascertain their attitudes toward living donation. Results: Among surveyed nephrologists, there was nearly universal support for living kidney donation as a viable medical option, and nearly all of them would support a healthy and medically cleared patient who wishes to participate. Although support was still strong, nephrologists were significantly less likely to support their friends and relatives participating in living kidney donation, and their support declined further for friends and relatives donating to nonrelatives. Conclusion: Our findings suggest the need to more deeply examine physician-perceived risks involved in serving as a living kidney donor. Based on differences in surveyed nephrologist attitudes regarding donation to and from loved ones versus nonrelatives, we suggest that physicians should give careful consideration to how they describe the risks of living donation to potential donors.

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