CVD, Diabetes Up Hospitalization Risk for LKDs

LIVING KIDNEY donors (LKDs) may have increased risks for end-stage kidney disease (ESKD) following nephrectomy. New study findings presented at the 2023 American Transplant Congress in San Diego, add that LKDs with diabetes or cardiovascular disease — risk factors for ESKD and its sequelae — are more likely to be hospitalized after donation. Amy Chang, MD, of Johns Hopkins University School of Medicine in Baltimore, Maryland, and colleagues studied postdonation hospitalization records from 2265 LKDs who underwent nephrectomy from 1968 to 2019. Median age at donation was 46 years.

Hospitalization within a median 7 years affected 42% of donors. The most common reasons for hospitalization were surgery (59%), cardiovascular causes (16%), and urologic problems (6%). The investigators predicted that up to half of living kidney donors would eventually experience hospitalization following nephrectomy. After adjusting for clinical characteristics, cardiovascular and diabetes history in the donor were significantly associated with 1.5- and 2.2-fold increased odds of hospitalization, the investigators reported. Hospitalization was not associated with patient sex, smoking history, education level, or income.

Hospitalization of living kidney donors may be “a sentinel event” for adverse outcomes, according to Dr Chang and colleagues.

“Since diabetes is the leading cause of [ESKD] in this population and cardiovascular disease is the leading cause of death in an [ESKD] population, hospitalization in donors presents a crucial opportunity to avert the most adverse long-term outcomes described in this population.” ■