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Renal outcome of living kidney donors aged more than 70 years

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Abstract

Background

The number of marginal living kidney donors has increased. Medically complex donors who have hypertension, older age, or low estimated glomerular filtration rate (eGFR) have been more likely to be used.

Methods

We conducted a retrospective cohort study of living kidney donors at a single center. We analyzed 309 living donors and divided them into three groups: group with older donors (aged ≥70 years) (n = 41), middle-aged (aged 46–69 years) (n = 239), and young donors (aged <46 years) (N = 29). Donor factors associated with chronic kidney disease (CKD) stage 3b or worse within 5 years post-donation were investigated.

Results

Of the 309 live donors, 86 (27.8%) developed CKD stage3b or worse within 5 years post-donation. The incidence of CKD stage3b or worse within 5 years post-donation was significantly higher in older donor (p < 0.01). Cox regression models revealed that older donor ages and lower eGFR were significantly related to the development of CKD stage3b or worse, independent of comorbidities such as obesity and hypertension [hazard ratio (95% CI); 4.59 (1.02–20.6), p = 047, 0.95 (0.94–0.96), p ≤ 0.01, respectively]. However, recovery of eGFR 4–5 years after donation was noted in the middle-aged and older donor groups, whereas the level of eGFR remained unchanged in the young group.

Conclusions

Older donors tend to develop CKD stage3b within 5 years post-donation but with the potential of recovery. Healthy older people (aged ≥70 years) could be candidates for living donors under careful monitoring of kidney function after donation.

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Data availability

The data which support the findings of this study are available from the corresponding author, [K.U.], upon reasonable request.

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Acknowledgements

We are grateful to “Editage” for assistance with the English proofreading.

Funding

The authors declare that they have no relevant financial interests.

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Authors and Affiliations

  1. Department of Organ Transplant Medicine, Tokyo Women’s Medical University, 8-1 Kawadacho, Shinjuku-Ku, Tokyo, 162-8666, Japan

    Rikako Oki, Kohei Unagami, Tomokazu Shimizu & Hideki Ishida

  2. Department of Nephrology, Tokyo Women’s Medical University, 8-1 Kawadacho, Shinjuku-Ku, Tokyo, 162-8666, Japan

    Rikako Oki, Kohei Unagami & Junichi Hoshino

  3. Department of Urology, Tokyo Women’s Medical University, Tokyo, Japan

    Rikako Oki, Kohei Unagami, Taro Banno, Toshihito Hirai, Kazuya Omoto, Tomokazu Shimizu & Toshio Takagi

  4. Department of Surgical Pathology, Tokyo Women’s Medical University, Tokyo, Japan

    Sekiko Taneda

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Contributions

RO, KU, and HI conceived the idea of the study. RO, KU and JH developed the statistical analysis plan and conducted statistical analyses. TB, TY, TH, KO, KK, TS, and ST contributed to the interpretation of the results. RO drafted the original manuscript. TT, and HI supervised the conduct of this study. All authors reviewed the manuscript draft and revised it critically on intellectual content. All authors approved the final version of the manuscript to be published.

Corresponding author

Correspondence to Kohei Unagami.

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The authors declare that they have no competing financial or other interest or personal relationship that could have influenced this paper or the study it describes.

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Oki, R., Unagami, K., Banno, T. et al. Renal outcome of living kidney donors aged more than 70 years. Clin Exp Nephrol (2024). https://doi.org/10.1007/s10157-024-02488-5

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