Department of Transplant Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Faculty of Medicine, University of Oslo, Oslo, Norway.
Nephrol Dial Transplant. 2022 Apr 25;37(5):928-936. doi: 10.1093/ndt/gfab054.
Previous reports suggest increased risk of hypertension and cardiovascular mortality after kidney donation. In this study we investigate the occurrence of ischaemic heart disease and cerebrovascular disease, diabetes and cancer in live kidney donors compared with healthy controls eligible for donation.
Different diagnoses were assessed in 1029 kidney donors and 16 084 controls. The diagnoses at follow-up were self-reported for the controls and registered by a physician for the donors. Stratified logistic regression was used to estimate associations with various disease outcomes, adjusted for gender, age at follow-up, smoking at baseline, body mass index at baseline, systolic blood pressure at baseline and time since the donation.
The mean observation time was 11.3 years [standard deviation (SD) 8.1] for donors versus 16.4 years (SD 5.7) for controls. The age at follow-up was 56.1 years (SD 12.4) in donors versus 53.5 years (SD 11.1) in controls and 44% of donors were males versus 39.3% in the controls. At follow-up, 35 (3.5%) of the donors had been diagnosed with ischaemic heart disease versus 267 (1.7%) of the controls. The adjusted odds ratio for ischaemic heart disease was 1.64 (confidence interval 1.10-2.43; P = 0.01) in donors compared with controls. There were no significant differences for the risks of cerebrovascular disease, diabetes or cancer.
During long-term follow-up of kidney donors, we found an increased risk of ischaemic heart disease compared with healthy controls. This information may be important in the follow-up and selection process of living kidney donors.
先前的报告表明，肾移植后高血压和心血管死亡率的风险增加。在这项研究中，我们调查了与有资格捐献的健康对照者相比，活体肾供者发生缺血性心脏病和脑血管疾病、糖尿病和癌症的情况。
在 1029 名肾供者和 16084 名对照者中评估了不同的诊断。对照者的随访诊断是自我报告的，而供者的随访诊断是由医生登记的。采用分层逻辑回归来估计与各种疾病结局的关联，调整了性别、随访时的年龄、基线时的吸烟状况、基线时的体重指数、基线时的收缩压和捐赠后的时间。
供者的平均观察时间为 11.3 年（标准差 [SD] 8.1），而对照者为 16.4 年（SD 5.7）。随访时的年龄供者为 56.1 岁（SD 12.4），对照者为 53.5 岁（SD 11.1），44%的供者为男性，而对照者为 39.3%。随访时，35 名（3.5%）供者被诊断为缺血性心脏病，而对照者中有 267 名（1.7%）。与对照者相比，供者发生缺血性心脏病的调整比值比为 1.64（95%置信区间 1.10-2.43；P=0.01）。在脑血管疾病、糖尿病或癌症的风险方面没有显著差异。
在对肾供者的长期随访中，我们发现与健康对照者相比，缺血性心脏病的风险增加。这些信息在活体肾供者的随访和选择过程中可能很重要。
