Is Kidney Donation Safe?
Long-term survival of donors is similar to that of healthy controls.
Availability of cadaveric kidneys is not increasing substantially, so live kidney donation (usually to a relative or close friend) is becoming more common. Researchers used a U.S. national registry to identify more than 80,000 live donors (from 1994 to 2009) and another national registry to identify an equal number of healthy controls (matched for demographic characteristics and comorbidities).
The number of live donors increased over time, from about 3000 to 6000 annually during the study period. Ninety-day postoperative mortality was 3.1 per 10,000 donors (in comparison, 90-day mortality is 18/10,000 for laparoscopic cholecystectomy and 260/10,000 for nondonor nephrectomy) and did not change over time even though average age at donation rose. Postoperative mortality was roughly three times higher in men than in women and in black donors than in white or Latino donors. Long-term mortality was similar in donors and in healthy controls.
Comment: Clinicians reasonably can reassure patients who are considering kidney donation that, beyond a small postoperative mortality risk, no excess long-term mortality is evident. The elevated postoperative mortality risk in certain subgroups, although still small compared with that of many surgical procedures, might require more detailed discussions.
Sunday, March 21, 2010
Monday, March 8, 2010
Sunday, March 7, 2010
11th March World Kidney Day
11th March World Kidney Day
Kidney diseases are Treatable
Detection: Kidney disease can be detected early. Simple laboratory tests are done on small samples of blood (to measure creatinine content and estimate GFR) and on urine (to measure creatinine and albumin excretion). The majority of individuals with early stages of CKD (chronic kidney disease) go undiagnosed, particularly in the developing world. The early detection of kidney impairment is essential and allows suitable treatment before kidney damage or cardiovascular problems occur.
Screening: Screening must be a priority for those people considered to be at high risk of kidney disease, namely:
Patients with diabetes mellitus and hypertension
Individuals who are obese or smoke
Individuals over 50 years of age
Individuals with a family history of kidney disease, diabetes mellitus or hypertension
Current kidney protective treatments should now be extended to those with early stages of CKD.
Key preventative measures have been defined and proven successful in protecting against both renal and cardiovascular disease, such as:
Reduction of high blood pressure: the lower the blood pressure, the slower the GFR decline
Specific medications to reduce proteinuria as well as lower blood pressure – ACE inhibitors/ARBs
Reduce salt intake to lower blood pressure
Control of glucose, blood lipids and anemia
Smoking cessation
Increased physical activity
Control of body weight
Treatment: Clinical research over the last decade has shown the potential benefit of blockade of the renin–angiotensin system by angiotensin converting enzyme inhibitors (ACEs) and angiotensin receptor blockers (ARBs) to significantly reduce the burden of disease from cardiovascular disease (CVD), diabetes, hypertension and CKD at relatively low cost
Kidney diseases are Treatable
Detection: Kidney disease can be detected early. Simple laboratory tests are done on small samples of blood (to measure creatinine content and estimate GFR) and on urine (to measure creatinine and albumin excretion). The majority of individuals with early stages of CKD (chronic kidney disease) go undiagnosed, particularly in the developing world. The early detection of kidney impairment is essential and allows suitable treatment before kidney damage or cardiovascular problems occur.
Screening: Screening must be a priority for those people considered to be at high risk of kidney disease, namely:
Patients with diabetes mellitus and hypertension
Individuals who are obese or smoke
Individuals over 50 years of age
Individuals with a family history of kidney disease, diabetes mellitus or hypertension
Current kidney protective treatments should now be extended to those with early stages of CKD.
Key preventative measures have been defined and proven successful in protecting against both renal and cardiovascular disease, such as:
Reduction of high blood pressure: the lower the blood pressure, the slower the GFR decline
Specific medications to reduce proteinuria as well as lower blood pressure – ACE inhibitors/ARBs
Reduce salt intake to lower blood pressure
Control of glucose, blood lipids and anemia
Smoking cessation
Increased physical activity
Control of body weight
Treatment: Clinical research over the last decade has shown the potential benefit of blockade of the renin–angiotensin system by angiotensin converting enzyme inhibitors (ACEs) and angiotensin receptor blockers (ARBs) to significantly reduce the burden of disease from cardiovascular disease (CVD), diabetes, hypertension and CKD at relatively low cost
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