{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:51:13Z","timestamp":1787028673453,"version":"build-2736575974"},"reference-count":24,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2020,1,25]],"date-time":"2020-01-25T00:00:00Z","timestamp":1579910400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Living kidney donation represents the optimal renal replacement therapy, but recent data suggest an increased long-term renal risk for the donor. Here, we evaluated the risk for reduced estimated glomerular filtration rate (eGFR), death, and major cardiovascular events such as nonfatal myocardial infarction or cerebrovascular event including TIA (transient ischemic attack) and stroke in 225 donors, who underwent pre-donation examinations and live donor nephrectomy between 1985 and 2014 at our center. The median follow-up time was 8.7 years (1.0\u201329.1). In multivariate analysis, age and arterial hypertension at baseline were significantly associated with a higher risk of adverse renal outcomes, such as (1) eGFR &lt;60 mL\/min\/1.73 m2 (age per year: HR (hazard ratio) 1.05, 95% confidence interval (CI) 1.03\u20131.08, hypertension: HR 2.25, 95% CI 1.22\u20133.98), (2) eGFR &lt;60 mL\/min\/1.73 m2 and a decrease of \u226540% from baseline (age: HR 1.08, 95% CI 1.03\u20131.13, hypertension: HR 4.22, 95% CI 1.72\u201310.36), and (3) eGFR &lt;45 mL\/min\/1.73 m2 (age: HR 1.12, 95% CI 1.05\u20131.20, hypertension: HR 5.06, 95% CI 1.49\u201317.22). In addition, eGFR at time of donation (per mL\/min\/1.73 m2) was associated with a lower risk of (1) eGFR &lt;60 mL\/min\/1.73 m2 (HR 0.98, 95% CI 0.97\u20131.00) and (2) eGFR &lt;45 mL\/min\/1.73 m2 (HR 0.95, 95% CI 0.90\u20131.00). Age was the only significant predictor for death or major cardiovascular event (HR 1.08, 95% CI 1.01\u20131.16). In conclusion, arterial hypertension, lower eGFR, and age at the time of donation are strong predictors for adverse renal outcomes in living kidney donors.<\/jats:p>","DOI":"10.3390\/jcm9020338","type":"journal-article","created":{"date-parts":[[2020,1,27]],"date-time":"2020-01-27T07:41:11Z","timestamp":1580110871000},"page":"338","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Arterial Hypertension as a Risk Factor for Reduced Glomerular Filtration Rate after Living Kidney Donation"],"prefix":"10.3390","volume":"9","author":[{"given":"Julia","family":"Kerschbaum","sequence":"first","affiliation":[{"name":"Department of Internal Medicine IV, Nephrology and Hypertension, Medical University Innsbruck, Anichstra\u00dfe 35, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Bitter","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine IV, Nephrology and Hypertension, Medical University Innsbruck, Anichstra\u00dfe 35, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Weitlaner","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine IV, Nephrology and Hypertension, Medical University Innsbruck, Anichstra\u00dfe 35, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrin","family":"Kienzl-Wagner","sequence":"additional","affiliation":[{"name":"Department of Visceral, Transplant, and Thoracic Surgery, Medical University Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1064-0098","authenticated-orcid":false,"given":"Hannes","family":"Neuwirt","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine IV, Nephrology and Hypertension, Medical University Innsbruck, Anichstra\u00dfe 35, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"B\u00f6sm\u00fcller","sequence":"additional","affiliation":[{"name":"Department of Visceral, Transplant, and Thoracic Surgery, Medical University Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gert","family":"Mayer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine IV, Nephrology and Hypertension, Medical University Innsbruck, Anichstra\u00dfe 35, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Schneeberger","sequence":"additional","affiliation":[{"name":"Department of Visceral, Transplant, and Thoracic Surgery, Medical University Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Rudnicki","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine IV, Nephrology and Hypertension, Medical University Innsbruck, Anichstra\u00dfe 35, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,1,25]]},"reference":[{"key":"ref_1","unstructured":"Cecka, J.M. (1995). Living donor transplants. Clin. Transpl., 363\u2013377."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1056\/NEJM199508103330601","article-title":"High survival rates of kidney transplants from spousal and living unrelated donors","volume":"333","author":"Terasaki","year":"1995","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2014","DOI":"10.1097\/01.TP.0000065176.06275.42","article-title":"The superior results of living-donor renal transplantation are not completely caused by selection or short cold ischemia time: A single-center, multivariate analysis","volume":"75","author":"Roodnat","year":"2003","journal-title":"Transplantation"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1093\/ndt\/gfw429","article-title":"Long-term risks of kidney living donation: Review and position paper by the ERA-EDTA DESCARTES working group","volume":"32","author":"Maggiore","year":"2017","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1001\/jama.2013.285141","article-title":"Risk of end-stage renal disease following live kidney donation","volume":"311","author":"Muzaale","year":"2014","journal-title":"JAMA"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1093\/ndt\/gfr303","article-title":"Overall and cardiovascular mortality in Norwegian kidney donors compared to the background population","volume":"27","author":"Mjoen","year":"2012","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2885","DOI":"10.1681\/ASN.2015091018","article-title":"Renal Function Profile in White Kidney Donors: The First 4 Decades","volume":"27","author":"Ibrahim","year":"2016","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e010869","DOI":"10.1136\/bmjopen-2015-010869","article-title":"Investigating kidney donation as a risk factor for hypertension and microalbuminuria: Findings from the Swiss prospective follow-up of living kidney donors","volume":"6","author":"Thiel","year":"2016","journal-title":"BMJ Open"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1097\/TP.0000000000001770","article-title":"KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors","volume":"101","author":"Lentine","year":"2017","journal-title":"Transplantation"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1056\/NEJMoa0804883","article-title":"Long-term consequences of kidney donation","volume":"360","author":"Ibrahim","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1111\/j.1440-1797.2007.00852.x","article-title":"Risk factors for MDRD-GFR of less than 60 mL\/min per 1.73 m2 in former kidney donors","volume":"12","author":"Lee","year":"2007","journal-title":"Nephrology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1111\/j.1600-6143.2012.04303.x","article-title":"Medical outcomes in African American live kidney donors: A matched cohort study","volume":"13","author":"Doshi","year":"2013","journal-title":"Am. J. Transplant."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1038\/ki.2010.483","article-title":"The definition, classification, and prognosis of chronic kidney disease: A KDIGO Controversies Conference report","volume":"80","author":"Levey","year":"2011","journal-title":"Kidney Int."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"276","DOI":"10.7326\/M17-1235","article-title":"Mid- and Long-Term Health Risks in Living Kidney Donors: A Systematic Review and Meta-analysis","volume":"168","author":"Ramond","year":"2018","journal-title":"Ann. Intern. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1406","DOI":"10.2215\/CJN.02110213","article-title":"The unjustified classification of kidney donors as patients with CKD: Critique and recommendations","volume":"8","author":"Matas","year":"2013","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1681\/ASN.2014030304","article-title":"The association of predonation hypertension with glomerular function and number in older living kidney donors","volume":"26","author":"Lenihan","year":"2015","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_17","first-page":"211","article-title":"The effect of low-dose dopamine on renal function in uninephrectomized patients: Special emphasis on kidney donors before and after nephrectomy","volume":"28","author":"Tegzess","year":"1987","journal-title":"Clin. Nephrol."},{"key":"ref_18","first-page":"461","article-title":"Response to acute protein load in kidney donors and in apparently normal postacute glomerulonephritis patients: Evidence for glomerular hyperfiltration","volume":"2","author":"Herrera","year":"1985","journal-title":"Lancet"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1159\/000183580","article-title":"Testing renal reserve filtration capacity with an amino acid solution","volume":"41","author":"Geerlings","year":"1985","journal-title":"Nephron"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2077","DOI":"10.1111\/j.1600-6143.2008.02355.x","article-title":"Nephrectomy elicits impact of age and BMI on renal hemodynamics: Lower postdonation reserve capacity in older or overweight kidney donors","volume":"8","author":"Rook","year":"2008","journal-title":"Am. J. Transplant."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"van Londen, M., Schaeffers, A., de Borst, M.H., Joles, J.A., Navis, G., and Lely, A.T. (2018). Overweight young female kidney donors have low renal functional reserve post-donation. Am. J. Physiol. Renal. Physiol.","DOI":"10.1152\/ajprenal.00492.2017"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1111\/j.1742-1241.2006.01037.x","article-title":"Renal functional reserve in obesity hypertension","volume":"60","author":"Pecly","year":"2006","journal-title":"Int. J. Clin. Pract."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1093\/ndt\/15.8.1162","article-title":"Dynamic renal function testing by compartmental analysis: Assessment of renal functional reserve in essential hypertension","volume":"15","author":"Zitta","year":"2000","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1038\/ki.2013.460","article-title":"Long-term risks for kidney donors","volume":"86","author":"Mjoen","year":"2014","journal-title":"Kidney Int."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/2\/338\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T13:20:37Z","timestamp":1760361637000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/2\/338"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,25]]},"references-count":24,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020,2]]}},"alternative-id":["jcm9020338"],"URL":"https:\/\/doi.org\/10.3390\/jcm9020338","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,25]]}}}