Article Text

Effects of living kidney donation on arterial stiffness: a systematic review protocol
  1. Rosendo A Rodriguez1,
  2. Mayra Trentin Sonoda2,
  3. Mohsen Agharazii3,
  4. Risa Shorr4,
  5. Kevin D Burns2
  1. 1Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
  2. 2Division of Nephrology, Kidney Research Centre, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
  3. 3Division of Nephrology, CHU de Québec-Université Laval Research Centre, Quebec City, Québec, Canada
  4. 4Learning Services, The Ottawa Hospital, Ottawa, Ontario, Canada
  1. Correspondence to Dr Rosendo A Rodriguez; rrodriguez1847{at}


Introduction Kidney donors have been reported to have accelerated progression of aortic stiffness and decreased glomerular filtration compared with healthy non-donors. This is a concern because increased aortic stiffness is an independent predictor of overall cardiovascular disease and all-cause mortality in the general population. To confirm if arterial stiffness increases after donation, we will systematically review all studies that evaluated indices of arterial stiffness in healthy individuals who underwent unilateral nephrectomy for kidney donation compared with age-matched healthy non-nephrectomised controls.

Methods/analysis We will comprehensively search for studies published between 1 January 1960 and 15 March 2021 in MEDLINE, EMBASE, Cochrane Central, OVID and EBM reviews. All prospective (cohort, case–control, case series and before-and-after studies) and retrospective non-randomised studies reporting indices of arterial stiffness in nephrectomised and non-nephrectomised healthy participants will be included. Primary outcome will be the difference in the functional metrics of arterial stiffness between donors and non-donors. Secondary outcomes will be the differences in systolic/diastolic blood pressures, serum creatinine, glomerular filtration, carotid artery intima–media thickness and vascular calcification. Study screening, selection and data extraction will be performed by two independent reviewers. Risk of bias will be independently assessed with the ROBINS-I tool and confidence in evidence by the Grading of Recommendations Assessment, Development and Evaluation recommendations. Qualitative and quantitative data syntheses as well as clinical and statistical heterogeneity (Forest plots, I2 and Cochran’s Q statistics) will be evaluated. If clinical and statistical heterogeneity are acceptable, inverse variance-weighted effects will be analysed by random effect models.

Ethics and dissemination No ethical approval is necessary. Our results will be disseminated through peer-review publication and presentations to guide stakeholders on the evaluation and follow-up care of kidney donors.

PROSPERO registration number CRD42020185551.

  • renal transplantation
  • transplant surgery
  • transplant medicine
  • clinical physiology
  • transplant surgery

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  • Contributors RAR and KDB conceived and designed the study; RAR created the analytical plan and drafted the protocol; RAR and RS designed the search strategy; RAR, MTS, MA and KDB will be involved in one or more of the following tasks: study screening and selection, data extraction, verification, quality appraisal, synthesis, analysis of the evidence and data interpretation. All authors have read, reviewed and approved the final version of the manuscript. RAR is the guarantor.

  • Funding This work is supported by Kidney Research Centre, Ottawa Hospital Research Institute, University of Ottawa.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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