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