EDITORIAL COMMENT The authors compare the risk of end-stage renal disease (ESRD) in 96217 kidney donors in the United States, followed for a median of 7.6 years with that of a healthy cohort of 20024 nondonors, followed for a median of 15 years of who are at equally low risk of renal disease and free of contraindications to live donation. Live kidney donors who are supposed to be “super healthy”; on average have excellent quality of life compared with healthy control individuals in the population. The authors were able to use a very healthy population of their country as a comparison group. However most analyses have included control groups less healthy than the living donor population and have had relatively short follow-up periods. Previously we didn’t have accurate information about a live donor’s lifetime risk of needing dialysis. The authors found that live kidney donors have an elevated relative risk of developing ESRD. However, the risk of reaching ESRD in the donor’s lifetime is very low. In this study estimated risk for ESRD would be less than 1% at 15 years for the donors in the United States. Nonetheless, that the risk for ESRD for live kidney donors remain lower than the risk for the average person in the population, but the risks are probably higher than if these “super healthy” people had never donated a kidney. These findings allowed us to have a precise understanding of the risks related to live kidney donation and may help to inform people better considering this option as a gift of life. SUGGESTED READING Mjøen G, Hallan S, Hartmann A, Foss A, Midtvedt K, Øyen O, Reisæter A, Pfeffer P, Jenssen T, Leivestad T, Line PD, Øvrehus M, Dale DO, Pihlstrøm H, Holme I, Dekker FW, Holdaas H. Long-term risks for kidney donors. Kidney Int 2014;86:162-167. Yarkin Kamil Yakupoglu MD
