HIRAI Toshihito
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Associate Professor
Article types Original article
Language English
Peer review Non peer reviewed
Title Renal outcome of living kidney donors aged more than 70 years
Journal Formal name：Clinical and experimental nephrology
Abbreviation：Clin Exp Nephrol
ISSN code：14377799/13421751
Domestic / ForeginForegin
Volume, Issue, Page pp.online
Author and coauthor Oki Rikako, Unagami Kohei, Banno Taro, Hirai Toshihito, Omoto Kazuya, Shimizu Tomokazu, Taneda Sekiko, Hoshino Junichi, Takagi Toshio, Ishida Hideki,
Publication date 2024/04/14
Summary 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.
DOI 10.1007/s10157-024-02488-5
PMID 38616218