No increase in cardiovascular events in living kidney donors

Patients selected for kidney donation show no increase in major cardiovascular events at several years’ follow-up compared with similarly healthy control individuals, reports a study in the British Medical Journal.

The retrospective study included 2028 people in Ontario, Canada, who were selected to become living kidney donors between 1992 and 2009. Provincial health data were used to match this group of donors to 20,280 nondonors, drawn from the healthiest segment of the general population.

The donors and nondonors were compared on a composite outcome of time to death or first major cardiovascular event. The median age at the time of donation was 45 years, and the median follow-up time was 6.5 years.

The primary outcome rate was significantly lower in the living kidney donors than in nondonor control individuals: 2.8 versus 4.1 events per 1000 person-years, hazard ratio 0.66. On a secondary outcome of time to first major cardiovascular event censored for death, there was no significant difference between groups: 1.7 versus 2.0 events per 1000 person-years for donors and nondonors, respectively. For donors and nondonors alike, the risks of death and cardiovascular events were higher for people of older age and lower income.

Cardiovascular disease is a key outcome of interest in assessing the long-term health risks of living kidney donation. This study of recent living donors in Canada finds no increase in the risk of major cardiovascular events within the first 10 years after donation, compared with a group of similarly healthy nondonors. The authors believe their results add to the evidence supporting the safety of living kidney donation as long as rigorous selection criteria continue to be followed [Garg AX, et al. Cardiovascular disease in kidney donors: matched cohort study. BMJ 2012; 344:e1203].