Optimising living kidney donor follow up
2018
Aim: To audit the effectiveness of an intervention intended to increase rate
of living kidney donor (LKD) follow-up.
Background: Post-donation follow-up care is recommended by KDIGO for
LKD. There is little long-term data of living kidney donors in Australia due to
incomplete follow-up. Methods: In 2012 we reported follow-up of LKD at 1 year of 70%, but less
than 10% at 5 years. Statewide follow-up was changed to be coordinated out
of a single follow-up centre, with tests and appointments organized by standard
mail. We reviewed the effectiveness of this intervention. Results: We identified 183 LKD, of which 126 (63% female, mean age
62 years, mean time since donation 9 years) were recorded in the both the
statewide database and the Living Kidney Donor Registry (LKDR)
@ANZDATA. Changing to a single, statewide follow-up centre achieved
50-70% of follow-up every year from 2014-17. This ranged from 75% at one
year post-donation, 61% at 5 and 48% > 5 years post-donation as recorded
locally in 2017. Reporting to the LKDR was lower at 25%, 33% & 22%
respectively. From the ANZDATA follow up, 63 patients had a recorded systolic
blood pressure measurement at their last follow up. 31% of these
patients had hypertension requiring anti-hypertensive medication with 1.3
the average number of agents required. Conclusions: The results show that clinical follow up decreases as time post
donation increases. Statewide coordination of donor follow-up improved
baseline results but there is still further improvement to be made. There is
discrepancy between local data and ANZDATA. Better coordination of these
two entities would allow for more accurate follow up data to be published.
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