The risk of ESRD in kidney transplant donors

  • Donald PotterEmail author
Letter to the Editor

Dear editors,

In their article “Towards adulthood with a solitary kidney” [1], in the section Long-term outcomes, the authors discuss the risk of end-stage renal disease (ESRD) in living kidney donors and cite data from two references [2, 3]. They state that “… the estimated risk of end-stage renal disease (ESRD) at 15 to 25 years after donation ranges between 8 and 11% compared to matched healthy non-donor counterparts” and note that the overall incidence of ESRD among donors was 302 cases per million. In the first study cited [2], 0.47% of the donors developed ESRD at a median time of 18.7 years after donation, and the overall incidence of ESRD was 0.03%. The risk of developing ESRD in the donors compared with controls was 11.38. In the second study [3], 0.1% of the donors developed ESRD at a mean time of 8.6 years after donation. The estimated cumulative incidence of ESRD at 15 years for donors was 0.31%, which was 7.8 times higher than the estimated cumulative incidence for controls. In the two studies, although the relative risk of ESRD in donors was 11 and 8 times the risk of matched controls, the cumulative incidence of ESRD at 15 years was less than 0.5%. These data do not support the authors’ conclusion that the risk of developing ESRD in living donors at 15–25 years after unilateral nephrectomy is 5 to 10% (question and answer 3b at the end of the paper).



  1. 1.
    Cochat P, Febvey O, Bacchetta J, Berard E, Cabrera N, Dubourg L (2019) Towards adulthood with a solitary kidney. Pediatr Nephrol 34:2311–2323CrossRefGoogle Scholar
  2. 2.
    Mjoen G, Hallan S, Hartman A, Foss A, Midvedt K, Oyen O, Reisaeter A, Pfeffer P, Jenssen T, Leivestad T, Line PD, Ovrehus M, Dale DO, Pihlstrom H, Holme I, Dekker FW, Holdaas H (2014) Long term risks for kidney donors. Kidney Int 86:162-167CrossRefGoogle Scholar
  3. 3.
    Muzaale AD, Massie AB, Wang MC, Montgomery MA, McBride MA, Wainright JL, Segev DL (2014) Risk of end-stage renal disease following live donor donation. JAMA 311:579–586CrossRefGoogle Scholar

Copyright information

© IPNA 2020

Authors and Affiliations

  1. 1.Department of PediatricsStanford University School of MedicinePalo AltoUSA

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