New Approaches in TransplantationKidney transplantationPostdonation Anemia in Living Kidney Donors

•Postdonation anemia is prevalent after living kidney donation.•Prevalence of postdonation anemia was 11.8% at a median follow-up time of 601 days.•Donor kidney volume and predonation hemoglobin levels are independent determinants for postdonation anemia.

BackgroundThe effect of nephrectomy on development of anemia in living kidney donation has not been well studied. We hypothesized that the remaining kidney volume and function after donation are determinants of hemoglobin (Hb) concentration and postdonation anemia (PDA).MethodsWe studied 398 living kidney donors (LKDs) who donated from January 2001 to December 2013. Demographic variables, hematologic variables, renal mass, and renal function were investigated as factors associated with PDA with the use of univariate and multivariable logistical regression analysis. Renal mass was determined from kidney volume measured with the use of computerized tomographic scans.ResultsPrevalence of PDA in LKDs was 11.8% at a median follow-up time of 601 days. In univariate analyses, PDA was more prevalent in women than in men (72% vs 28%; P = .048). Age and race were not associated factors. Kidney volume was lower in donors with PDA than in those without PDA (326 ± 52 mL vs 368 ± 70 mL; P < .001). Donors with and without PDA had similar predonation and postdonation glomerular filtration rates. In the multivariable logistic regression analysis, total kidney volume and predonation anemia remained as independent factors associated with PDA.ConclusionsPDA is prevalent after living kidney donation, with donor kidney volume and predonation hemoglobin levels being independent determinants for PDA.