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Acute dialysis risk in living kidney donors.

https://arctichealth.org/en/permalink/ahliterature127475
Source
Nephrol Dial Transplant. 2012 Aug;27(8):3291-5
Publication Type
Article
Date
Aug-2012
Author
Ngan Lam
Anjie Huang
Liane S Feldman
John S Gill
Martin Karpinski
Joseph Kim
Scott W Klarenbach
Greg A Knoll
Krista L Lentine
Chris Y Nguan
Chirag R Parikh
G V Ramesh Prasad
Darin J Treleaven
Ann Young
Amit X Garg
Author Affiliation
Department of Medicine, Division of Nephrology, University of Western Ontario, London, Canada.
Source
Nephrol Dial Transplant. 2012 Aug;27(8):3291-5
Date
Aug-2012
Language
English
Publication Type
Article
Keywords
Acute Kidney Injury - etiology - therapy
Adult
Cohort Studies
Female
Follow-Up Studies
Humans
Kidney Transplantation
Living Donors
Male
Middle Aged
Nephrectomy - adverse effects
Ontario
Renal Dialysis
Risk factors
Tissue and Organ Procurement
Abstract
Reduced kidney function confers a higher risk of acute kidney injury at the time of an inciting event, such as sepsis. Whether the same is true in those with reduced renal mass from living kidney donation is unknown.
We conducted a population-based matched cohort study of all living kidney donors in the province of Ontario, Canada who underwent donor nephrectomy from 1992 to 2009. We manually reviewed the medical records of these living kidney donors and linked this information to provincial health care databases. Non-donors were selected from the healthiest segment of the general population.
There were 2027 donors and 20 270 matched non-donors. The median age was 43 years (interquartile range 34-50) and individuals were followed for a median of 6.6 years (maximum 17.7 years). The primary outcome was acute dialysis during any hospital stay. Reasons for hospitalization included infectious diseases, cardiovascular diseases and hematological malignancies. Only one donor received acute dialysis in follow-up (6.5 events per 100 000 person-years), a rate which was statistically no different than 14 non-donors (9.4 events per 100 000 person-years).
These results are reassuring for the practice of living kidney donation. Longer follow-up of this and other donor cohorts will provide more precise estimates about this risk.
Notes
Cites: Kidney Int. 2006 Nov;70(10):1801-1017003822
Cites: Transplantation. 2006 Dec 27;82(12):1646-817198252
Cites: Crit Care. 2007;11(2):R3117331245
Cites: J Clin Epidemiol. 2008 Apr;61(4):344-918313558
Cites: N Engl J Med. 2009 Jan 29;360(5):459-6919179315
Cites: Stat Med. 2009 Nov 10;28(25):3083-10719757444
Cites: Am J Transplant. 2009 Nov;9(11):2514-919681812
Cites: Am J Kidney Dis. 2010 Sep;56(3):486-9520557989
Cites: N Engl J Med. 2010 Aug 19;363(8):797-820818884
Cites: Am J Kidney Dis. 2011 Jan;57(1):29-4321184918
Cites: Kidney Int. 2011 Jul;80(1):93-10421289597
Comment In: Nephrol Dial Transplant. 2012 Aug;27(8):3021-322619313
PubMed ID
22290988 View in PubMed
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Attitudes to sharing personal health information in living kidney donation.

https://arctichealth.org/en/permalink/ahliterature144792
Source
Clin J Am Soc Nephrol. 2010 Apr;5(4):717-22
Publication Type
Article
Date
Apr-2010
Author
Patricia Hizo-Abes
Ann Young
Peter P Reese
Phil McFarlane
Linda Wright
Meaghan Cuerden
Amit X Garg
Author Affiliation
London Kidney Clinical Research Unit, Room ELL-101, Westminster, London Health Sciences Centre, 800 Commissioners Road East, London, Ontario N6A 4G5, Canada.
Source
Clin J Am Soc Nephrol. 2010 Apr;5(4):717-22
Date
Apr-2010
Language
English
Publication Type
Article
Keywords
Access to Information - legislation & jurisprudence
Adult
Aged
Attitude of Health Personnel
Confidentiality - legislation & jurisprudence - psychology
Cross-Sectional Studies
Female
Health Knowledge, Attitudes, Practice
Health Policy
Health Records, Personal
Humans
Informed Consent - legislation & jurisprudence - psychology
Kidney Transplantation - legislation & jurisprudence - psychology
Living Donors - legislation & jurisprudence - psychology
Male
Middle Aged
Ontario
Patient Education as Topic
Practice Guidelines as Topic
Questionnaires
Abstract
In living kidney donation, transplant professionals consider the rights of a living kidney donor and recipient to keep their personal health information confidential and the need to disclose this information to the other for informed consent. In incompatible kidney exchange, personal health information from multiple living donors and recipients may affect decision making and outcomes.
We conducted a survey to understand and compare the preferences of potential donors (n = 43), potential recipients (n = 73), and health professionals (n = 41) toward sharing personal health information (in total 157 individuals).
When considering traditional live-donor transplantation, donors and recipients generally agreed that a recipient's health information should be shared with the donor (86 and 80%, respectively) and that a donor's information should be shared with the recipient (97 and 89%, respectively). When considering incompatible kidney exchange, donors and recipients generally agreed that a recipient's information should be shared with all donors and recipients involved in the transplant (85 and 85%, respectively) and that a donor's information should also be shared with all involved (95 and 90%, respectively). These results were contrary to attitudes expressed by transplant professionals, who frequently disagreed about whether such information should be shared.
Future policies and practice could facilitate greater sharing of personal health information in living kidney donation. This requires a consideration of which information is relevant, how to put it in context, and a plan to obtain consent from all concerned.
Notes
Cites: Am J Transplant. 2003 Jul;3(7):830-412814474
Cites: Am J Transplant. 2009 Jul;9(7):1558-7319459792
Cites: Transplantation. 2004 Aug 27;78(4):491-215446304
Cites: Lancet. 1992 Oct 3;340(8823):807-101357243
Cites: Can J Surg. 2004 Dec;47(6):408-1315646438
Cites: Transplantation. 2005 Mar 27;79(6 Suppl):S53-6615785361
Cites: HIV Med. 2006 Apr;7(3):133-916494626
Cites: Ann Intern Med. 2006 Aug 1;145(3):185-9616880460
Cites: J Pers Assess. 2006 Dec;87(3):305-1617134338
Cites: Clin J Am Soc Nephrol. 2006 Nov;1(6):1148-5317699340
Cites: Am J Transplant. 2008 Sep;8(9):1878-9018671676
Cites: Nephrol Dial Transplant. 2008 Oct;23(10):3316-2418599559
Cites: N Engl J Med. 2009 Mar 12;360(11):1096-10119279341
Cites: J Med Ethics. 2009 Apr;35(4):270-119332587
Cites: Kidney Int. 2009 May;75(10):1088-9819225540
Cites: Am J Transplant. 2004 Oct;4(10):1553-415367208
PubMed ID
20299371 View in PubMed
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Cardiovascular disease after Escherichia coli O157:H7 gastroenteritis.

https://arctichealth.org/en/permalink/ahliterature118823
Source
CMAJ. 2013 Jan 8;185(1):E70-7
Publication Type
Article
Date
Jan-8-2013
Author
Patricia Hizo-Abes
William F Clark
Jessica M Sontrop
Ann Young
Anjie Huang
Heather Thiessen-Philbrook
Peter C Austin
Amit X Garg
Author Affiliation
Division of Nephrology, Department of Medicine, Western University, London, Ont., Canada.
Source
CMAJ. 2013 Jan 8;185(1):E70-7
Date
Jan-8-2013
Language
English
Publication Type
Article
Keywords
Cardiovascular Diseases - etiology - microbiology
Chi-Square Distribution
Disease Outbreaks
Escherichia coli Infections - complications - epidemiology - microbiology
Escherichia coli O157
Female
Gastroenteritis - complications - epidemiology - microbiology
Heart Failure - etiology - microbiology
Humans
Male
Middle Aged
Myocardial Infarction - etiology - microbiology
Ontario - epidemiology
Risk factors
Statistics, nonparametric
Stroke - etiology - microbiology
Abstract
Escherichia coli O157:H7 is one cause of acute bacterial gastroenteritis, which can be devastating in outbreak situations. We studied the risk of cardiovascular disease following such an outbreak in Walkerton, Ontario, in May 2000.
In this community-based cohort study, we linked data from the Walkerton Health Study (2002-2008) to Ontario's large healthcare databases. We included 4 groups of adults: 3 groups of Walkerton participants (153 with severe gastroenteritis, 414 with mild gastroenteritis, 331 with no gastroenteritis) and a group of 11 263 residents from the surrounding communities that were unaffected by the outbreak. The primary outcome was a composite of death or first major cardiovascular event (admission to hospital for acute myocardial infarction, stroke or congestive heart failure, or evidence of associated procedures). The secondary outcome was first major cardiovascular event censored for death. Adults were followed for an average of 7.4 years.
During the study period, 1174 adults (9.7%) died or experienced a major cardiovascular event. Compared with residents of the surrounding communities, the risk of death or cardiovascular event was not elevated among Walkerton participants with severe or mild gastroenteritis (hazard ratio [HR] for severe gastroenteritis 0.74, 95% confidence interval [CI] 0.38-1.43, mild gastroenteritis HR 0.64, 95% CI 0.42-0.98). Compared with Walkerton participants who had no gastroenteritis, risk of death or cardiovascular event was not elevated among participants with severe or mild gastroenteritis.
There was no increase in the risk of cardiovascular disease in the decade following acute infection during a major E. coli O157:H7 outbreak.
Notes
Cites: J Clin Epidemiol. 2006 Apr;59(4):421-816549265
Cites: Infect Immun. 2005 Dec;73(12):8306-1616299328
Cites: J Am Soc Nephrol. 2008 May;19(5):841-318322159
Cites: Kidney Int Suppl. 2009 Feb;(112):S33-419180129
Cites: BMJ. 2010;340:b508720228141
Cites: Lancet. 2010 Jun 12;375(9731):2073-8120483451
Cites: BMJ. 2010;341:c602021084368
Cites: J Am Soc Nephrol. 2011 May;22(5):939-4621493769
Cites: Med Care. 2011 Oct;49(10):940-721921849
Cites: BMJ. 2012;344:e120322381674
Cites: Ann Intern Med. 2012 Apr 17;156(8):560-922508733
Cites: CMAJ. 2012 Aug 7;184(11):1237-4522733671
Cites: Kidney Int. 2012 Oct;82(8):903-822695327
Cites: Kidney Int. 2001 Sep;60(3):831-4611532079
Cites: Circulation. 2002 Jan 1;105(1):15-2111772870
Cites: Ann Periodontol. 2001 Dec;6(1):1-811887452
Cites: Am Heart J. 2002 Aug;144(2):290-612177647
Cites: Med Care. 2002 Aug;40(8):675-8512187181
Cites: J Am Soc Nephrol. 2002 Sep;13(9):2239-4512191968
Cites: Infect Immun. 1988 Sep;56(9):2373-83044997
Cites: Am J Epidemiol. 1989 Jan;129(1):125-372910056
Cites: Infect Immun. 1991 Nov;59(11):4173-91937774
Cites: Am J Public Health. 1992 Feb;82(2):243-81739155
Cites: J Clin Epidemiol. 1992 Jun;45(6):613-91607900
Cites: J Biol Chem. 1993 Jul 25;268(21):15484-88340376
Cites: Am J Epidemiol. 1993 Dec 1;138(11):923-368256780
Cites: Ann Intern Med. 1995 Nov 1;123(9):698-7147574226
Cites: J Am Coll Cardiol. 1996 May;27(6):1335-428626941
Cites: Kidney Int. 1997 Apr;51(4):1245-569083293
Cites: J Am Soc Nephrol. 1997 Dec;8(12):1877-889402090
Cites: J Am Coll Cardiol. 1998 May;31(6):1217-259581711
Cites: Kidney Int. 1998 Aug;54(2):426-379690209
Cites: Biochem Biophys Res Commun. 1998 Oct 9;251(1):137-419790920
Cites: N Engl J Med. 1999 Jan 14;340(2):115-269887164
Cites: Emerg Infect Dis. 2005 Apr;11(4):603-915829201
Cites: Can J Public Health. 2005 Mar-Apr;96(2):125-3015850033
Cites: CMAJ. 2005 Aug 2;173(3):261-815923490
Cites: Med Care. 2006 Nov;44(11):1011-917063133
PubMed ID
23166291 View in PubMed
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Cardiovascular disease in kidney donors: matched cohort study.

https://arctichealth.org/en/permalink/ahliterature126545
Source
BMJ. 2012;344:e1203
Publication Type
Article
Date
2012
Author
Amit X Garg
Aizhan Meirambayeva
Anjie Huang
Joseph Kim
G V Ramesh Prasad
Greg Knoll
Neil Boudville
Charmaine Lok
Philip McFarlane
Martin Karpinski
Leroy Storsley
Scott Klarenbach
Ngan Lam
Sonia M Thomas
Christine Dipchand
Peter Reese
Mona Doshi
Eric Gibney
Ken Taub
Ann Young
Author Affiliation
Division of Nephrology, Department of Medicine, University of Western Ontario, London, ON, Canada. amit.garg@lhsc.on.ca
Source
BMJ. 2012;344:e1203
Date
2012
Language
English
Publication Type
Article
Keywords
Adult
Cardiovascular Diseases - epidemiology
Child
Cohort Studies
Comorbidity
Female
Humans
Kidney Transplantation - statistics & numerical data
Living Donors - statistics & numerical data
Male
Middle Aged
Ontario - epidemiology
Outcome Assessment (Health Care) - statistics & numerical data
Retrospective Studies
Risk factors
Abstract
To determine whether people who donate a kidney have an increased risk of cardiovascular disease.
Retrospective population based matched cohort study.
All people who were carefully selected to become a living kidney donor in the province of Ontario, Canada, between 1992 and 2009. The information in donor charts was manually reviewed and linked to provincial healthcare databases. Matched non-donors were selected from the healthiest segment of the general population. A total of 2028 donors and 20,280 matched non-donors were followed for a median of 6.5 years (maximum 17.7 years). Median age was 43 at the time of donation (interquartile range 34-50) and 50 at the time of follow-up (42-58).
The primary outcome was a composite of time to death or first major cardiovascular event. The secondary outcome was time to first major cardiovascular event censored for death.
The risk of the primary outcome of death and major cardiovascular events was lower in donors than in non-donors (2.8 v 4.1 events per 1000 person years; hazard ratio 0.66, 95% confidence interval 0.48 to 0.90). The risk of major cardiovascular events censored for death was no different in donors than in non-donors (1.7 v 2.0 events per 1000 person years; 0.85, 0.57 to 1.27). Results were similar in all sensitivity analyses. Older age and lower income were associated with a higher risk of death and major cardiovascular events in both donors and non-donors when each group was analysed separately.
The risk of major cardiovascular events in donors is no higher in the first decade after kidney donation compared with a similarly healthy segment of the general population. While we will continue to follow people in this study, these interim results add to the evidence base supporting the safety of the practice among carefully selected donors.
Notes
Cites: Ann Intern Med. 2006 Aug 1;145(3):185-9616880460
Cites: J Urol. 2011 May;185(5):1820-521420113
Cites: Int Surg. 2010 Oct-Dec;95(4):343-921309419
Cites: N Engl J Med. 2010 Aug 19;363(8):797-820818884
Cites: Am J Kidney Dis. 2010 Sep;56(3):486-9520557989
Cites: BMJ. 2003 Jan 25;326(7382):21912543843
Cites: JAMA. 2003 Apr 2;289(13):1652-812672733
Cites: JAMA. 2003 Jun 25;289(24):3241-212824204
Cites: Lancet. 2004 May 29;363(9423):1751-615172772
Cites: N Engl J Med. 2004 Aug 5;351(6):543-5115295047
Cites: Transplantation. 1997 Oct 15;64(7):976-89381544
Cites: N Engl J Med. 1999 Oct 28;341(18):1359-6710536129
Cites: Transplantation. 2005 Mar 27;79(6 Suppl):S53-6615785361
Cites: BMJ. 2005 Apr 23;330(7497):960-215845982
Cites: Am J Transplant. 2006 Jun;6(6):1479-8516686774
Cites: Nephrol Dial Transplant. 2012 Jan;27(1):443-721636826
Cites: Kidney Int. 2006 Nov;70(10):1801-1017003822
Cites: Nephron Clin Pract. 2007;107(3):c82-917890875
Cites: J Clin Epidemiol. 2008 Apr;61(4):344-918313558
Cites: Transplantation. 2008 Aug 15;86(3):399-40618698242
Cites: Am J Transplant. 2008 Sep;8(9):1878-9018671676
Cites: N Engl J Med. 2009 Jan 29;360(5):459-6919179315
Cites: Transplantation. 2009 Feb 15;87(3):419-2319202449
Cites: Kidney Int. 2009 May;75(10):1088-9819225540
Cites: JAMA. 2010 Mar 10;303(10):959-6620215610
Cites: Lancet. 2010 Jun 12;375(9731):2073-8120483451
Comment In: Am J Kidney Dis. 2013 Feb;61(2):194-622917667
Comment In: Nat Rev Nephrol. 2012 May;8(5):25322430057
Comment In: BMJ. 2012;344:e116722381673
Comment In: BMJ. 2012;344:e272722514223
Comment In: BMJ. 2012;344:e272422514221
PubMed ID
22381674 View in PubMed
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Discovering misattributed paternity in living kidney donation: prevalence, preference, and practice.

https://arctichealth.org/en/permalink/ahliterature150815
Source
Transplantation. 2009 May 27;87(10):1429-35
Publication Type
Article
Date
May-27-2009
Author
Ann Young
Sang Joseph Kim
Eric M Gibney
Chirag R Parikh
Meaghan S Cuerden
Lucy D Horvat
Patricia Hizo-Abes
Amit X Garg
Author Affiliation
Division of Nephrology, University of Western Ontario, London, ON, Canada.
Source
Transplantation. 2009 May 27;87(10):1429-35
Date
May-27-2009
Language
English
Publication Type
Article
Keywords
Adult
Attitude
Canada
Child
Father-Child Relations
HLA Antigens - genetics
Humans
Kidney
Kidney Transplantation - physiology - psychology
Living Donors
Male
Oregon
Paternity
Registries
Truth Disclosure
United States
Abstract
When evaluating a living kidney donor and recipient with a father-child relationship, it may be discovered that the two are not biologically related. We analyzed data from the United Network for Organ Sharing and the Canadian Organ Replacement Registry to determine how frequently this occurs. We surveyed 102 potential donors, recipients, and transplant professionals for their opinion on whether such information should be disclosed to the donor-recipient pair. We communicated with transplant professionals from 13 Canadian centers on current practices for handling this information. In the United States and Canada, the prevalence of father-child living kidney donor-recipient pairs with less than a one-haplotype human leukocyte antigen match (i.e., misattributed paternity) is between 1% and 3%, or approximately 0.25% to 0.5% of all living kidney donations. Opinions about revealing this information were variable: 23% strongly favored disclosure; whereas, 24% were strongly opposed to it. Current practices are variable; some centers disclose this information, whereas others do not. Discovering misattributed paternity in living donation is uncommon but can occur. Opinions on how to deal with this sensitive information are variable. Discussion among transplant professionals will facilitate best practices and policies. Strategies adopted by some centers can be considered.
PubMed ID
19461476 View in PubMed
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Fracture risk in living kidney donors: a matched cohort study.

https://arctichealth.org/en/permalink/ahliterature125528
Source
Am J Kidney Dis. 2012 Jun;59(6):770-6
Publication Type
Article
Date
Jun-2012
Author
Amit X Garg
Jennie Pouget
Ann Young
Anjie Huang
Neil Boudville
Anthony Hodsman
Jonathan D Adachi
William D Leslie
Suzanne M Cadarette
Charmaine E Lok
Mauricio Monroy-Cuadros
G V Ramesh Prasad
Sonia M Thomas
Kyla Naylor
Darin Treleavan
Author Affiliation
Division of Nephrology, Department of Medicine, Western University, London, Canada. amit.garg@lhsc.on.ca
Source
Am J Kidney Dis. 2012 Jun;59(6):770-6
Date
Jun-2012
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Case-Control Studies
Confidence Intervals
Databases, Factual
Female
Follow-Up Studies
Fractures, Spontaneous - epidemiology - etiology - physiopathology
Humans
Incidence
Kidney Transplantation - methods
Living Donors
Logistic Models
Male
Middle Aged
Nephrectomy - adverse effects - methods
Ontario - epidemiology
Poisson Distribution
Proportional Hazards Models
Reference Values
Retrospective Studies
Risk assessment
Sex Distribution
Time Factors
Abstract
Chronic kidney disease increases the risk of bone fragility fractures (osteoporotic fractures). Living kidney donors lose 50% of their renal mass and show changes in calcium homeostasis. We studied whether living kidney donation increases the risk of fragility fracture.
Retrospective matched-cohort study.
We reviewed the medical charts of all 2,015 adults in Ontario, Canada, who donated a kidney between 1992 and 2009 (surgeries performed across 5 transplant programs). We linked this information to health care databases and randomly selected 20,150 matched nondonors from the healthiest portion of the general population. Median age was 43 (95% CI, 24-50) years at study enrollment. Donors and nondonors were then followed up for a median of 6.6 years and a maximum of 17.7 years.
Living donor nephrectomy.
The primary outcome was lower- and upper-extremity fragility fractures. Individuals who reached 66 years or older in follow-up had bisphosphonate prescriptions recorded.
The rate of fragility fracture was no higher in donors compared with nondonors (16.4 vs 18.7 events/10,000 person-years; rate ratio, 0.88; 95% CI, 0.58-1.32). Results were similar in multiple additional analyses. There was little difference in the proportion of older adults in follow-up who received a bisphosphonate prescription (17.1% vs 15.2%; P = 0.4).
These are interim results. Ongoing surveillance of this and other donor cohorts is warranted to be sure an association does not manifest with longer follow-up.
To date, there is no evidence of increased fragility fracture risk in living kidney donors. Our results meet an information need and are reassuring for the safety of the practice.
PubMed ID
22472209 View in PubMed
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Hemodialysis in a satellite unit: clinical performance target attainment and health-related quality of life.

https://arctichealth.org/en/permalink/ahliterature134551
Source
Clin J Am Soc Nephrol. 2011 Jul;6(7):1692-9
Publication Type
Article
Date
Jul-2011
Author
Michael J Diamant
Ann Young
Kerri Gallo
Wang Xi
Rita S Suri
Amit X Garg
Louise M Moist
Author Affiliation
Division of Nephrology, Department of Medicine, London Health Sciences Centre, London, Ontario, Canada.
Source
Clin J Am Soc Nephrol. 2011 Jul;6(7):1692-9
Date
Jul-2011
Language
English
Publication Type
Article
Keywords
Aged
Ambulatory Care Facilities - standards
Biological Markers - blood
Calcium - blood
Chi-Square Distribution
Community health centers - standards
Cross-Sectional Studies
Female
Health status
Health Status Indicators
Hemodialysis Units, Hospital - standards
Hemoglobins - analysis
Humans
Kidney Failure, Chronic - blood - psychology - therapy
Logistic Models
Male
Middle Aged
Odds Ratio
Ontario
Outcome and Process Assessment (Health Care) - standards
Phosphates - blood
Quality Indicators, Health Care - standards
Quality of Life
Questionnaires
Renal Dialysis - adverse effects - standards
Risk assessment
Risk factors
Serum Albumin - analysis
Treatment Outcome
Abstract
In Canada, patients are increasingly receiving hemodialysis (HD) in satellite units, which are closer to their community but further from tertiary care hospitals and their nephrologists. The process of care is different in the satellites with fewer visits from nephrologists and reliance on remote communication. The objective of this study is to compare clinical performance target attainment and health-related quality of life (HRQOL) in patients receiving HD in satellite versus in-center units.
The London Health Sciences Centre in London, Ontario, Canada, has both tertiary care center and satellite HD units. All eligible patients who received dialysis treatment at one of these units as of July 24, 2008, were enrolled into a cross-sectional study (n = 522). Patient attainment of hemoglobin, albumin, calcium-phosphate (Ca-P) product, Kt/V, and vascular access targets were compared. Participants were also administered the Kidney Disease Quality of Life Short-Form questionnaire.
Satellite patients were more likely to attain clinical performance targets for albumin (adjusted odds ratio [OR] = 4.87 [95% confidence interval [CI]: 2.13 to 11.14]), hemoglobin (OR = 1.59 [95% CI: 1.08 to 2.35]), and Ca-P product (OR = 2.02 [95% CI: 1.14 to 3.60]), as well as for multiple targets (P
PubMed ID
21566106 View in PubMed
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Long-term medical outcomes among Aboriginal living kidney donors.

https://arctichealth.org/en/permalink/ahliterature142731
Source
Transplantation. 2010 Aug 27;90(4):401-6
Publication Type
Article
Date
Aug-27-2010
Author
Leroy J Storsley
Ann Young
David N Rush
Peter W Nickerson
Julie Ho
Vuthana Suon
Martin Karpinski
Author Affiliation
Department of Medicine, University of Manitoba, Winnipeg, MB, Canada.
Source
Transplantation. 2010 Aug 27;90(4):401-6
Date
Aug-27-2010
Language
English
Publication Type
Article
Keywords
Body Weight
Creatinine - blood
Female
Follow-Up Studies
Humans
Indians, North American
Kidney Transplantation - physiology
Living Donors
Male
Manitoba
Middle Aged
Ontario
Parents
Proteinuria - epidemiology
Siblings
Treatment Outcome
Abstract
It is unknown whether favorable long-term data on the safety of living kidney donation can be extrapolated to populations at higher risk of chronic kidney disease. Indigenous people (i.e., Aboriginals) have a high prevalence of risk factors for chronic kidney disease and Aboriginal living donor outcomes need to be defined.
We performed a retrospective cohort study of all 38 Aboriginal donors donating at our center since 1970 and 76 randomly selected white donor controls to determine the long-term rates of hypertension, diabetes, and renal function postdonation.
Follow-up was obtained for 91% of both Aboriginal and white donors (mean follow-up approximately 14 years). Hypertension has been diagnosed more frequently among Aboriginal donors (Ab 42% vs. white 19%, P=0.02). Notably, all 11 Aboriginal donors more than 20 years postdonation have developed hypertension. Diabetes has also been diagnosed more frequently among Aboriginal donors (Ab 19% vs. white 2%, P=0.005), including 5 of 11 (45%) more than 20 years postdonation. Follow-up estimated glomerular filtration rate was higher in Aboriginal donors (Ab 77+/-17 vs. white 67+/-13 mL/min/1.73 m, P=0.002) but not significantly different in adjusted analyses. One Aboriginal donor developed end-stage renal disease 14 years postdonation.
Aboriginal living kidney donors at our center have high rates of hypertension and diabetes on long-term follow-up, although renal function is preserved to date. This profile is similar to that of the general unselected Aboriginal population despite detailed medical evaluation before donation. These findings have important implications for donor counseling and may have implications for other high-risk donor populations.
PubMed ID
20562735 View in PubMed
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8 records – page 1 of 1.