Long-term medical risks to the living kidney donor

Key PointsTransplantation of kidneys from living donors is an important treatment for kidney failure, but the long-term risks to kidney donors are unclear; understanding the risks could improve the informed consent processStudies suggest that living kidney donors are at increased risk of developing end-stage renal disease relative to healthy nondonors, but the 15-year cumulative incidence remains <1%All-cause mortality in the first decade after nephrectomy seems to be lower or no different among donors than among healthy nondonors; one study suggests that over 25 years, the incidence might increase by 5%The absolute incidence of gout might increase by <2% in the first decade after donation among donors compared with healthy matched nondonorsWomen should be informed that complications of pregnancy are more likely after donation than before donation and that their risk of gestational hypertension and pre-eclampsia is 6% higher than that in nondonorsRisks of acute kidney injury, cardiovascular events, kidney stones requiring surgical intervention, major gastrointestinal bleeding and skeletal fractures do not seem to be increased in the decade after kidney donation