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Living Donor Research Living Donor Risks Living Kidney Donor

Cardiovascular Changes Shown in Living Kidney Donors

It’s well established that a reduction in kidney function (GFR) significantly increases one’s risk of cardiovascular disease and death. It’s all known that folks in all stages of chronic kidney disease are at risk for heart troubles.

Finally, a few researchers got together and decided to look at how living kidney donor’s hearts change post-nephrectomy.

 

“We hypothesised that the reduction in GFR associated with nephrectomy causes increased left ventricular (LV) mass, impaired LV function and increased aortic stiffness.”

 

“Compared to controls, nephrectomy in donors was associated with increases in [left ventricular] mass ; [left ventricular] mass-volume ratio and [carotid-femoral pulse wave velocity] PWV ; and reductions in aortic distensibility [flexibiity; ie. more stiffness] and global circumferential strain”

 

“Change in GFR independently predicted the change in LV mass (R2=0.26; P<0.01).”

 

“Nephrectomy causes concentric LV remodelling and dysfunction, increased aortic stiffness and adverse changes in[cardiovascular]  CV biomarkers. These findings suggest reduced GFR is an independent causative CV risk factor and that donors should be under long-term CV review.”

 
Moody, W., Ferro, C., Edwards, N., Chue, C., Lin, E., Taylor, R., Cockwell, P., Steeds, R., & Townend, J. (2015). EFFECTS OF NEPHRECTOMY ON CARDIOVASCULAR STRUCTURE AND FUNCTION IN LIVING KIDNEY DONORS Journal of the American College of Cardiology, 65 (10) DOI: 10.1016/S0735-1097(15)62150-7

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Living Donor Research Living Kidney Donor

Post-Operative Kidney Function in Living Kidney Donors vs. Renal Cell Cancer

The authors compared 94 pairs of living kidney donors and folks who underwent nephrectomy due a cancerous kidney tumor.

Median pre-nephrectomy GFR was nearly equal for both groups.

But:

 

In living kidney donors, median eGFR decreased by 34.4 % immediately after surgery. Compared with matched RN-patients, immediate postoperative [kidney function] is significantly more pronounced.

 

And:

The percentage decrease in living kidney donors was higher than the comparison group too.

 

Why? They don’t know for sure, but one theory is that the folks with renal cancer were already exhibiting signs of hyperfiltration prior to surgery.

 
Vergho, D., Burger, M., Schrammel, M., Brookman-May, S., Gierth, M., Hoschke, B., Lopau, K., Gilfrich, C., Riedmiller, H., Wolff, I., & May, M. (2014). Matched-pair analysis of renal function in the immediate postoperative period: a comparison of living kidney donors versus patients nephrectomized for renal cell cancer World Journal of Urology DOI: 10.1007/s00345-014-1423-1