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A retrospective review with prospective follow up of renal function, blood pressure and proteinuria post living donor nephrectomy at Groote Schuur Hospital, Cape Town South Africa

Introduction: Renal transplantation is the treatment of choice for patients with end stage renal disease [ESRD]. An increased risk of ESRD has been demonstrated when comparing donors to age matched healthy non-donors. There are no outcome data in Africa on long term donor renal function or mortality...

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Main Author: Murugan, Ashley
Other Authors: Dave, Nicola
Format: Thesis
Language:English
Published: Department of Medicine 2020
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access_status_str Open Access
author Murugan, Ashley
author2 Dave, Nicola
author_browse Dave, Nicola
Murugan, Ashley
author_facet Dave, Nicola
Murugan, Ashley
author_sort Murugan, Ashley
collection Thesis
description Introduction: Renal transplantation is the treatment of choice for patients with end stage renal disease [ESRD]. An increased risk of ESRD has been demonstrated when comparing donors to age matched healthy non-donors. There are no outcome data in Africa on long term donor renal function or mortality. Therefore, this study aimed to assess long term health complications in the living donor population and evaluate risk factors associated with poor health outcomes of the donors. Methods: This was a retrospective review with prospective follow up of persons undergoing living related donor nephrectomy for renal transplantation, at Groote Schuur Hospital (GSH) from January 2005 to November 2017. We retrospectively analysed baseline demographics, clinical information including blood pressure and renal function (creatinine, eGFR and proteinuria) and compared them with follow up blood pressure and renal function. Results: The majority of the donors were of mixed ancestry 94/154(61%) and 1st degree relatives 111/154 (72%) of which 63/111 (56.8%) donors were siblings. Hypertension developed in 16/31 (51.6%) donors at follow-up. Those developing hypertension had a higher mean baseline blood pressure (systolic blood pressure 139±11.3 mmHg and diastolic blood pressure 85.5±7.3 mmHg). 21/49(42.9%) developed chronic kidney disease [CKD], of which, 16 donors had an eGFR < 60 ml/min/1.73m2 . In those that developed CKD there was a higher percentage of males (p=0.018) and they were older (p=0.048) at baseline. Baseline systolic and diastolic blood pressures was not statistically different in those that developed CKD. 3/31(9.6%) donors developed diabetes. Conclusions: In South Africa, CKD is on the rise and the need for kidney donors for patients with ESRD is therefore also increasing. This study demonstrates that our living donors are at increased risk of CKD and hypertension and therefore need to be followed up more rigorously.
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license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2020
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spelling oai:open.uct.ac.za:11427/32310 A retrospective review with prospective follow up of renal function, blood pressure and proteinuria post living donor nephrectomy at Groote Schuur Hospital, Cape Town South Africa Murugan, Ashley Dave, Nicola post donor nephrectomy outcomes chronic kidney disease diabetes hypertension renal transplant Introduction: Renal transplantation is the treatment of choice for patients with end stage renal disease [ESRD]. An increased risk of ESRD has been demonstrated when comparing donors to age matched healthy non-donors. There are no outcome data in Africa on long term donor renal function or mortality. Therefore, this study aimed to assess long term health complications in the living donor population and evaluate risk factors associated with poor health outcomes of the donors. Methods: This was a retrospective review with prospective follow up of persons undergoing living related donor nephrectomy for renal transplantation, at Groote Schuur Hospital (GSH) from January 2005 to November 2017. We retrospectively analysed baseline demographics, clinical information including blood pressure and renal function (creatinine, eGFR and proteinuria) and compared them with follow up blood pressure and renal function. Results: The majority of the donors were of mixed ancestry 94/154(61%) and 1st degree relatives 111/154 (72%) of which 63/111 (56.8%) donors were siblings. Hypertension developed in 16/31 (51.6%) donors at follow-up. Those developing hypertension had a higher mean baseline blood pressure (systolic blood pressure 139±11.3 mmHg and diastolic blood pressure 85.5±7.3 mmHg). 21/49(42.9%) developed chronic kidney disease [CKD], of which, 16 donors had an eGFR < 60 ml/min/1.73m2 . In those that developed CKD there was a higher percentage of males (p=0.018) and they were older (p=0.048) at baseline. Baseline systolic and diastolic blood pressures was not statistically different in those that developed CKD. 3/31(9.6%) donors developed diabetes. Conclusions: In South Africa, CKD is on the rise and the need for kidney donors for patients with ESRD is therefore also increasing. This study demonstrates that our living donors are at increased risk of CKD and hypertension and therefore need to be followed up more rigorously. 2020-10-16T10:01:56Z 2020-10-16T10:01:56Z 2020 2020-10-16T09:41:54Z Master Thesis Masters MMed http://hdl.handle.net/11427/32310 eng application/pdf Department of Medicine Faculty of Health Sciences
spellingShingle post donor nephrectomy outcomes
chronic kidney disease
diabetes
hypertension
renal transplant
Murugan, Ashley
A retrospective review with prospective follow up of renal function, blood pressure and proteinuria post living donor nephrectomy at Groote Schuur Hospital, Cape Town South Africa
thesis_degree_str Master's
title A retrospective review with prospective follow up of renal function, blood pressure and proteinuria post living donor nephrectomy at Groote Schuur Hospital, Cape Town South Africa
title_full A retrospective review with prospective follow up of renal function, blood pressure and proteinuria post living donor nephrectomy at Groote Schuur Hospital, Cape Town South Africa
title_fullStr A retrospective review with prospective follow up of renal function, blood pressure and proteinuria post living donor nephrectomy at Groote Schuur Hospital, Cape Town South Africa
title_full_unstemmed A retrospective review with prospective follow up of renal function, blood pressure and proteinuria post living donor nephrectomy at Groote Schuur Hospital, Cape Town South Africa
title_short A retrospective review with prospective follow up of renal function, blood pressure and proteinuria post living donor nephrectomy at Groote Schuur Hospital, Cape Town South Africa
title_sort retrospective review with prospective follow up of renal function blood pressure and proteinuria post living donor nephrectomy at groote schuur hospital cape town south africa
topic post donor nephrectomy outcomes
chronic kidney disease
diabetes
hypertension
renal transplant
url http://hdl.handle.net/11427/32310
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