Donor-Recipient Relationship and Risk of ESKD in Live Kidney Donors of Varied Racial Groups.
Adult
Ethnicity
Female
Follow-Up Studies
Graft Survival
Humans
Incidence
Interpersonal Relations
Kidney Failure, Chronic
/ ethnology
Kidney Transplantation
Living Donors
/ psychology
Male
Middle Aged
Nephrectomy
Registries
Retrospective Studies
Risk Factors
Transplant Recipients
/ psychology
United States
/ epidemiology
Kidney donation
ancestry
biological relationship
donor-recipient relationship
end-stage renal disease (ESRD)
family history of disease
health risks
kidney failure
living-related donor
offspring
parent
race/ethnicity
renal transplantation
risk of ESRD
sibling
Journal
American journal of kidney diseases : the official journal of the National Kidney Foundation
ISSN: 1523-6838
Titre abrégé: Am J Kidney Dis
Pays: United States
ID NLM: 8110075
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
received:
05
08
2018
accepted:
19
08
2019
pubmed:
17
11
2019
medline:
1
5
2020
entrez:
17
11
2019
Statut:
ppublish
Résumé
Risk factors for kidney failure are the basis of live kidney donor candidate evaluation. We quantified risk for end-stage kidney disease (ESKD) by the biological relationship of the donor to the recipient, a risk factor that is not addressed by current clinical practice guidelines. Retrospective cohort study. A cohort of 143,750 US kidney donors between 1987 and 2017. Biological relationship of donor and recipient. ESKD. Donors' records were linked to national dialysis and transplantation registries to ascertain development of the outcome. Donors were observed over a median of 12 (interquartile range, 6-18; maximum, 30) years. Survival analysis methods that account for the competing risk for death were used. Risk for ESKD varied by orders of magnitude across donor-recipient relationship categories. For Asian donors, risks compared with unrelated donors were 259.4-fold greater for identical twins (95% CI, 19.5-3445.6), 4.7-fold greater for full siblings (95% CI, 0.5-41.0), 3.5-fold greater for offspring (95% CI, 0.6-39.5), 1.0 for parents, and 1.0 for half-sibling or other biological relatives. For black donors, risks were 22.5-fold greater for identical twin donors (95% CI, 4.7-107.0), 4.1-fold for full siblings (95% CI, 2.1-7.8), 2.7-fold for offspring (95% CI, 1.4-5.4), 3.1-fold for parents (95% CI, 1.4-6.8), and 1.3-fold for half-sibling or other biological relatives (95% CI, 0.5-3.3). For white donors, risks were 3.5-fold greater for identical twin donors (95% CI, 0.5-25.3), 2.0-fold for full siblings (95% CI, 1.4-2.8), 1.4-fold for offspring (95% CI, 0.9-2.3), 2.9-fold for parents (95% CI, 2.0-4.1), and 0.8-fold for half-sibling or other biological relatives (95% CI, 0.3-1.6). Insufficient sample size in some race and relationship groups. Absence of data for family history of kidney disease for donors biologically unrelated to their recipients. Marked differences in risk for ESKD across types of donor-recipient relationship were observed for Asian, black, and white donors. These findings warrant further validation with more robust data to better inform clinical practice guidelines.
Identifiants
pubmed: 31732232
pii: S0272-6386(19)31013-3
doi: 10.1053/j.ajkd.2019.08.020
pmc: PMC7042071
mid: NIHMS1542839
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
333-341Subventions
Organisme : NIDDK NIH HHS
ID : R01 DK113980
Pays : United States
Organisme : NIDDK NIH HHS
ID : K23 DK103918
Pays : United States
Organisme : NIDDK NIH HHS
ID : K24 DK101828
Pays : United States
Organisme : NIDDK NIH HHS
ID : F32 DK109662
Pays : United States
Organisme : NIDDK NIH HHS
ID : K01 DK101677
Pays : United States
Organisme : AHRQ HHS
ID : K01 HS024600
Pays : United States
Organisme : NIAID NIH HHS
ID : K24 AI144954
Pays : United States
Organisme : NIDDK NIH HHS
ID : K01 DK114388
Pays : United States
Organisme : NIDDK NIH HHS
ID : R01 DK096008
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2019 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
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