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Comment & Response |

Kidney Donation and Risk of ESRD—Reply

Abimereki D. Muzaale, MD, MPH1; Allan B. Massie, PhD, MHS1; Dorry L. Segev, MD, PhD1
[+] Author Affiliations
1Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
JAMA. 2014;312(1):93-94. doi:10.1001/jama.2014.5524.
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In Reply Drs Niemi and Mandelbrot express concerns that some of our NHANES exclusion criteria might be too stringent, rendering the healthy nondonor comparison group healthier than donors and less likely to develop ESRD. Although we agree that a history of mild asthma or remotely treated thyroid malignancy would not preclude donation, it also seems unlikely that these diseases would cause ESRD.

Dr Matas and colleagues express concern that donors have more factors associated with increased risk of ESRD such as significantly higher systolic blood pressure and body mass index; however, we are skeptical that clinicians would consider systolic blood pressure of 1.8 mm Hg or body mass index of 0.5 to be significantly higher. Regardless, we have previously shown that the same healthy nondonors are not healthier: they have a higher mortality than donors,1 and it is unlikely that attributes causing higher mortality also cause lower ESRD risk.

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July 2, 2014
Arthur J. Matas, MD; Jonas Wadstrom, MD, PhD; Hassan N. Ibrahim, MD
1Department of Surgery, University of Minnesota, Minneapolis
2Department of Transplantation, Karolinska University Hospital, Stockholm, Sweden
3Department of Medicine, University of Minnesota, Minneapolis
JAMA. 2014;312(1):92-93. doi:10.1001/jama.2014.5515.
July 2, 2014
Bryce Kiberd, MD; Karthik Tennankore, MD
1Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
JAMA. 2014;312(1):93. doi:10.1001/jama.2014.5518.
July 2, 2014
Matthew Niemi, MD; Didier A. Mandelbrot, MD
1Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
2Transplant Center, Beth Israel Deaconess Medical Center, Boston, Massachusetts
JAMA. 2014;312(1):92. doi:10.1001/jama.2014.5521.
July 2, 2014
Lainie Friedman Ross, MD, PhD; J. Richard Thistlethwaite Jr, MD, PhD
1Department of Pediatrics, University of Chicago, Chicago, Illinois
2Department of Surgery, University of Chicago, Chicago, Illinois
JAMA. 2014;312(1):94. doi:10.1001/jama.2014.6111.
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