Is there no detriment to donating a kidney? Should we really look down on people that refuse to donate a kidney to save a life?
People can get by okay with one kidney, if they’re healthy to start with.
Some folks shouldn’t donate a kidney, though. Common conditions which keep one from donating (as a live donor, anyway) are hypertension, diabetes, a history of most types of cancers, and (wait for it) kidney disease.
But some of these things are things that someone is likely to develop with old age. It almost sounds as if kidney donation is like giving up 5-10 years of your life. What are the statistics on kidney donors?
Not fully known yet.
Meta-Analysis: Risk for Hypertension in Living Kidney Donors
The risk of living kidney donation
Here are some cites:
Overall, the results of this study are overwhelmingly positive and have encouraged us to continue living donor kidney transplants.
*Results: Forty-one subjects had died between 15 months and 31 years after the donation. The mortality pattern was similar to that in the general population, the majority dying of cardiovascular diseases and malignancies. After 20 years of follow-up, 85% of the donors were alive, whereas the expected survival rate was 66%. Survival was thus 29% better in the donor group. One third of the donors (aged 46-91 years) who had donated >20 years ago had hypertension. There was a deterioration in the renal function with increasing age, similar to what is seen among normal healthy subjects. The average glomerular filtration rate in donors aged 75 years and over was 48 ml/min/1.73 m2.
Conclusions: To donate a kidney does not seem to constitute any long-term risk. The better survival among donors is probably due to the fact that only healthy persons are accepted for living kidney donation.*
http://www.blackwell-synergy.com/links/doi/10.1034/j.1600-6143.2003.00126.x/abs/
- Between 1/1/1999 and 7/1/2001, these centers carried out 10 828 living donor nephrectomies: 52.3% open, 20.7% hand-assisted LN, and 27% non-hand-assisted LN. Two donors (0.02%) died from surgical complications and one is in a persistent vegetative state (all after LN). Reoperation was necessary in 22 (0.4%) open, 23 (1.0%) hand-assisted LN, and 21 (0.9%) non-hand-assisted LN cases (p = 0.001). Complications not requiring reoperation were reported for 19 (0.3%) open, 22 (1.0%) hand-assisted LN, and 24 (0.8%) non-hand-assisted LN cases (p = 0.02). Readmission rate was higher for LN (1.6%) vs. open (0.6%) donors (p < 0.001), almost entirely as a result of an increase in gastrointestinal complications in LN donors.
Morbidity and mortality for living donor nephrectomy at transplant centers in the United States remain low.*
And for the dissenting view:
*Results. A total of 56 previous living donors were identified as having been subsequently listed for cadaveric kidney transplantation. Forty-three have received transplants; 36 currently have functioning grafts. One died after transplantation. Two candidates died while waiting.
Conclusions. Living renal donation has long-term risks that may not be apparent in the short term. The numbers here reported underestimate the actual number of living donors with renal failure, because they include only patients listed for a kidney transplant. To determine risk factors for postdonation renal failure, long-term living-donor follow-up data are needed.*
Some kind mod might wander by and fix those long links, please.
While kidney donation hasn’t been extensively studied, there seems to be no difference in lifespan between kidney donors and the general population.
When I donated in 2004, I was aware of two relevant studies (on review, I’m glad that DrDeth has provided others.) A study of WWII vets who had nephrectomies after being injured showed no significant affect on lifespan or health except for a risk of developing hypertension later in life. A more recent study seemed to show that there was no difference between the long term outlook for kidney donors and the general population.
The biggest problem is that there still isn’t that much data out there. The second study that I mentioned was small enough that a man who was hit by a softball was statistically significant.
Personally, I was willing to give up, statistically speaking, about five years of my life for a family member. As it turns out I probably don’t have to worry, though I really should get my weight under control.
Thanks to Qadgop and DrDeth for some excellent links.
Indeed, in Qad’s Annal of Internal Medicine article, it notes that:
I know it doesn’t sound like much, but these type of increases, at least when considered over large populations of individuals are clear and major risks for complications of high blood pressure such as stroke, heart attack, and (ironically, here) kidney failure. Of course, I am not all trying to discourage people from doating. OTOH, there may be well be a long term (future) risk associated from this altruistic practice and prospective donors should not have such information withheld.
Oh yeah, for the right person my kidney’s their kidney. I’m just trying to decide where to draw the line. Does the second cousin that got in a knife fight with his dealer count, or should I wait until my sister has a bad infection.
No problemo. I want to point out that QtM (and you too!) are the real medical experts. I am just very good at searching scientific articles and getting to the gist of them. I know just a tad more than a layman about medicine, but I search well. 
A related question: What happens to the void where the kidney was? Do they fill it with something or do the other organs just kind of slosh around and fill in the space?
Nothing is put in to fill the space. Everything moves around to take up the space.
For what it’s worth, the organs don’t slosh around; the peritoneum holds everything in place. When I donated, the surgeon mentioned that he had to cut through a lot of extra tissue to get the kidney out (he referred to it as scar tissue, though I don’t know how I could have scarred in the middle of my gut.) Apparently, this isn’t that unusual for males.