Center Variation and Risk Factors for Failure to Complete 6 Month Postdonation Follow-up Among Obese Living Kidney Donors. Academic Article uri icon

Overview

abstract

  • BACKGROUND: Living kidney donors in the United States who were obese at donation are at increased risk of end-stage renal disease and may benefit from intensive postdonation follow-up. However, they are less likely to have complete follow-up data. Center variation and risk factors for incomplete follow-up are unknown. METHODS: Adult living kidney donors with obesity (body mass index, ≥30 kg/m) at donation reported to the Scientific Registry of Transplant Recipients from January 2005 to July 2015 were included (n = 13 831). Donor characteristics were compared by recorded serum creatinine at 6 months postdonation, and multilevel logistic regression models were used to estimate odds of 6-month creatinine. RESULTS: After adjustment, older age, female sex, and donation after implementation of new center follow-up requirements were associated with higher odds of 6-month creatinine, with lower odds for obese donors with a history of smoking, biologically related donors, and at centers with higher total living donor volume. 23% of variation in recorded 6-month serum creatinine among obese donors was attributed to center (intraclass correlation coefficient: 0.232, P < 0.001). The adjusted probability of 6-month creatinine by center ranged from 10% to 91.5%. CONCLUSIONS: Tremendous variation in recorded 6-month postdonation serum creatinine exists among obese living donors, with high volume centers having the lowest probability of follow-up. Moreover, individual-level characteristics such as age, sex, and relationship to recipient were associated with recorded 6-month creatinine. Given increased risk for end-stage renal disease among obese living donors, center-level efforts targeted specifically at increasing postdonation follow-up among obese donors should be developed and implemented.

publication date

  • July 1, 2019

Research

keywords

  • Aftercare
  • Donor Selection
  • Healthcare Disparities
  • Kidney Transplantation
  • Living Donors
  • Nephrectomy
  • Obesity
  • Practice Patterns, Physicians'

Identity

PubMed Central ID

  • PMC6597173

Scopus Document Identifier

  • 85068842383

Digital Object Identifier (DOI)

  • 10.1097/TP.0000000000002508

PubMed ID

  • 31241556

Additional Document Info

volume

  • 103

issue

  • 7