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BMC Nephrology
Published in: BMC Nephrology 1/2023

Open Access 01-12-2023 | Study Protocol

The Minnesota attributable risk of kidney donation (MARKD) study: a retrospective cohort study of long-term (> 50 year) outcomes after kidney donation compared to well-matched healthy controls

Authors: David M. Vock, Erika S. Helgeson, Aidan F. Mullan, Naim S. Issa, Sujana Sanka, Alison C. Saiki, Kristin Mathson, Alanna M. Chamberlain, Andrew D. Rule, Arthur J. Matas

Published in: BMC Nephrology | Issue 1/2023

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Abstract

Background

There is uncertainty about the long-term risks of living kidney donation. Well-designed studies with controls well-matched on risk factors for kidney disease are needed to understand the attributable risks of kidney donation.

Methods

The goal of the Minnesota Attributable Risk of Kidney Donation (MARKD) study is to compare the long-term (> 50 years) outcomes of living donors (LDs) to contemporary and geographically similar controls that are well-matched on health status. University of Minnesota (n = 4022; 1st transplant: 1963) and Mayo Clinic LDs (n = 3035; 1st transplant: 1963) will be matched to Rochester Epidemiology Project (REP) controls (approximately 4 controls to 1 donor) on the basis of age, sex, and race/ethnicity. The REP controls are a well-defined population, with detailed medical record data linked between all providers in Olmsted and surrounding counties, that come from the same geographic region and era (early 1960s to present) as the donors. Controls will be carefully selected to have health status acceptable for donation on the index date (date their matched donor donated). Further refinement of the control group will include confirmed kidney health (e.g., normal serum creatinine and/or no proteinuria) and matching (on index date) of body mass index, smoking history, family history of chronic kidney disease, and blood pressure. Outcomes will be ascertained from national registries (National Death Index and United States Renal Data System) and a new survey administered to both donors and controls; the data will be supplemented by prior surveys and medical record review of donors and REP controls. The outcomes to be compared are all-cause mortality, end-stage kidney disease, cardiovascular disease and mortality, estimated glomerular filtration rate (eGFR) trajectory and chronic kidney disease, pregnancy risks, and development of diseases that frequently lead to chronic kidney disease (e.g. hypertension, diabetes, and obesity). We will additionally evaluate whether the risk of donation differs based on baseline characteristics.

Discussion

Our study will provide a comprehensive assessment of long-term living donor risk to inform candidate living donors, and to inform the follow-up and care of current living donors.
Appendix
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Metadata
Title
The Minnesota attributable risk of kidney donation (MARKD) study: a retrospective cohort study of long-term (> 50 year) outcomes after kidney donation compared to well-matched healthy controls
Authors
David M. Vock
Erika S. Helgeson
Aidan F. Mullan
Naim S. Issa
Sujana Sanka
Alison C. Saiki
Kristin Mathson
Alanna M. Chamberlain
Andrew D. Rule
Arthur J. Matas
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Nephrology / Issue 1/2023
Electronic ISSN: 1471-2369
DOI
https://doi.org/10.1186/s12882-023-03149-7

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