A Study of Renal Outcomes in African American Living Kidney Donors

Background. Little is known about the long-term outcomes of African American living kidney donors (AALKDs). We undertook this study to describe renal outcomes of AALKDs several years after donation. Methods. We invited 107 AALKDs to come for follow-up health evaluation. Results. Thirty-nine subjects (36.4%) completed evaluation at a mean of 7.1 +/- 1.6 (range, 3.9-10.2) years postdonation. The mean estimated glomerular filtration rate using the abbreviated Modification of Diet in Renal Disease equation [eGFR(MDRD)] at follow-up was 72.1 +/- 16.3 (range, 42-106) mL/min/1.73 m(2), and 18% of subjects had an eGFR(MDRD) of 30 to 59. The mean absolute and relative decrease in eGFR(MDRD) from the time of donation to follow-up was 30.5 +/- 16.4 mL/min/ 1.73 m(2) and 28.8%, respectively. Subjects whose body mass index was more than or equal to 35 kg/m(2) (n=8) were found to have a greater decrement in c(MDRD) than those with body mass index less than 35 kg/m(2) (40.1 +/- 7.3 and 28.3 +/- 17.1 mL/min/1.73 m(2), respectively; P=0.009). Sixteen (41%) were hypertensive at follow-up, as defined as treatment with antihypertensive medications (n=8) or average blood pressure of more than or equal to 140 systolic or 90 mm Hg diastolic (n = 10, of whom two were on antihypertensive medications). One subject had macroalbuminuria (>300 mu g/mg creatinine), and six (15.4%) had microalbuminuria (30-300 mu g/mg creatinine). Conclusions. AALKDs experience a substantial incidence of hypertension and a modest drop in eGFR(MDRD) postdonation, and obesity may increase the magnitude of renal decline. Further study is urgently needed to determine the long-term risks of AALKDs.