Outcomes of Living Kidney Donors with Rheumatoid Arthritis

Abstract

Background— Patients with rheumatoid arthritis are more likely to have reduced kidney function develop over time. The aim of this study was to assess the clinical and safety outcomes of living kidney donors with rheumatoid arthritis. Methods— A retrospective cohort study at a tertiary referral hospital to assess the outcomes of living kidney donors with rheumatoid arthritis. All 6 adults with rheumatoid arthritis who underwent nephrectomy as living kidney donors between January 2000 and September 2014 were included. Eighteen nondonors with rheumatoid arthritis (3 nondonors per donor) were randomly selected for comparison by matching the year of birth and comorbidity score. Results— None of the donors with rheumatoid arthritis had a flare-up of arthritis at a median follow-up time of 5.9 years (interquartile range [IQR], 3.1–7.5 years), while 5 (27.8%) nondonors with rheumatoid arthritis had a flare-up at a median follow-up time of 4.7 years (IQR, 3.1–6.7 years). After nephrectomy, donors' estimated glomerular filtration rate decreased to a mean of 43.53 (SD, 4) mL/min per 1.73 m2 at 7 days after the index date. The estimated glomerular filtration rate of donors subsequently increased significantly at rate of 3.99 mL/min per 1.73 m2 ( P< .001). None of the donors with rheumatoid arthritis had end-stage renal disease develop or died at median follow-up times of 5.9 (IQR, 3.1–7.5) years and 8.2 (IQR, 5.8–9.7) years, respectively. Conclusion— Healthy kidney donors with rheumatoid arthritis have good outcomes, with no increased risk of decline in renal function, end-stage renal disease, or death.