While there have been numerous studies of living kidney donors, most have been retrospective without suitable controls and have yielded conflicting results. To clarify this we studied 205 living donor candidates and 203 controls having no medical conditions precluding donation. Before and at six months, one, two, three, six, and nine years after donation we measured iohexol glomerular filtration rate, clinic blood pressure, urine protein excretion and metabolic parameters reported to be affected by kidney function. We measured 24 hour ambulatory blood pressure at three, six, and nine years and at six and nine years blood pressure after treadmill exercise, carotid-femoral pulse wave velocity and arterial elasticity. Between six months and nine years, the mean (95% confidence interval) change in glomerular filtration rate was significantly different among 133 donors 0·02 (-0·16−0·20) mL/min/1·73m²/year versus -1·26 (-1·52−-1·00) mL/min/1·73m²/year in 113 healthy controls. Blood pressure, urine protein, urine albumin, glucose, hemoglobin A1c, insulin, and lipoproteins were not different in controls versus donors; but parathyroid hormone, homocysteine and uric acid remained higher at nine years. At six and nine years carotid-femoral pulse wave velocity was not different, but the mean small artery elasticity was significantly lower in 141 donors 6·1 mL/mmHg x100, versus 113 controls 7·1 mL/mmHg x100, and 6·1 mL/mmHg x100 in 137 donors versus 7·6 mL/mmHg x100 in 112 controls at six and nine years, respectively [significant adjusted difference of 1·1 mL/mmHg x100]. Thus, donors remain healthy with stable kidney function for the first nine years, but differences in metabolic and vascular parameters could be harbingers of adverse outcomes requiring future interventions.

尽管有许多关于活体肾脏供体的研究，但大多数回顾性研究都没有适当的对照，并且产生了矛盾的结果。为了澄清这一点，我们研究了205名活着的捐献者候选人和203名没有任何医疗状况的捐献者。在捐赠后的六个月（分别是捐赠后的一，二，三，六和九年之前和六个月），我们测量了碘海醇肾小球滤过率，临床血压，尿蛋白排泄和据称受肾功能影响的代谢参数。我们在跑步机锻炼后的3年，6年和9年以及6年和9年时测量了24小时动态血压，颈股动脉脉搏波速度和动脉弹性。在六个月到九年之间，² /年和-1·26（-1·52−-1·00）mL / min / 1·73m ²/年在113个健康对照中。对照组和供体的血压，尿蛋白，尿白蛋白，葡萄糖，血红蛋白A1c，胰岛素和脂蛋白无差异。但是甲状旁腺激素，同型半胱氨酸和尿酸在第九年仍然较高。在第6和第9年，颈股动脉脉搏波速度没有变化，但是141个供血者6·1 mL / mmHg x100的平均小动脉弹性明显降低，而113个对照者为7·1 mL / mmHg x100和6·1分别在6年和9年时，137个供体的mL / mmHg x100与112个对照组的7·6 mL / mmHg x100相比[调整后的差异为1·1 mL / mmHg x100]。因此，在最初的九年中，捐献者保持肾脏功能稳定，保持健康，但是新陈代谢和血管参数的差异可能预示着不良后果，需要进一步的干预。