Living kidney-donation: is the donator sheltered from cardiovascular risk factors?
Malek Mojaat1, Manel Ben Salah1, Mariem Ben Salem1, Insaf Handous1, Mouna Hamouda1, Ahmed Letaief1, Sabra Aloui1, Habib Skhiri1.
1Nephrology, dialysis and kidney transplantation, Fattouma Bourguiba University Hospital, Monastir, Tunisia
Introduction: Living kidney transplantation represents the best therapeutic option for end-stage kidney disease patients. However, a multitude of questions has arisen regarding the risks encountered by the donor following kidney donation, namely cardiovascular risk factors such as diabetes and hypertension.
Methods: Herein is a monocentric, retrospective, descriptive and analytical study reporting data relative to blood pressure and glycemic equilibrium among 40 living kidney-donors that were admitted in our department of nephrology and kidney transplantation with the purpose of donating and were followed-up in our consultation. Clinical and biological data were collected before the donation and during every visit thereafter.
Results: Median follow-up was 9 years. The median age was 42 years.75% were female.62% were married.80% of donors were related to the recipient. One donor had a history of hypertension well-controlled on monotherapy. Pre donation work up showed: the median systolic and diastolic blood pressures at baseline were 112,5 and 70 mmHg respectively and that of glycemia was 4,88mmol/l. The median time of hospitalization was 5 days. During follow-up, and comparatively, with pre-donation assessment, systolic and diastolic blood pressures were relatively stable with significantly higher blood pressure at long term only (p=0,03 for each). Two patients developed hypertension after donation and both were well-controlled on monotherapy. The median of glycemia has shown a progressive increase during the study period of 5 years with a significant difference at short and long term only (p-value of 0,02 and 0,006 respectively). One donor has developed diabetes that was well-controlled on metformin. One female donor had 2 pregnancies without gestational diabetes no hypertension or preeclampsia. No death was observed and no cardiovascular events were encountered.
Conclusion: Our results show that living kidney donation can be safely performed provided that a meticulous evaluation of the donors is ensured prior to nephrectomy. Moreover, a regular follow-up is paramount allowing an early screening for complications and a prompt initiation of treatment.
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