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Example:10.1021/acsami.1c06204 or Chem. Rev., 2007, 107, 2411-2502
Economic Impact of Donating a Kidney on Living Donors: A Korean Cohort Study
American Journal of Kidney Diseases  (IF8.86),  Pub Date : 2021-08-20, DOI: 10.1053/j.ajkd.2021.07.009
Sehoon Park, Jina Park, Eunjeong Kang, Jang Wook Lee, Yaerim Kim, Minsu Park, Kwangsoo Kim, Hyo Jeong Kim, Miyeun Han, Jang-Hee Cho, Jung Pyo Lee, Sik Lee, Soo Wan Kim, Sang Min Park, Dong-Wan Chae, Ho Jun Chin, Yong Chul Kim, Yon Su Kim, Hajeong Lee

Rationale & objective

Although existing studies have reported adverse health outcomes following kidney donation, its socioeconomic impact on living donors requires further study.

Study design

A retrospective observational cohort study including a matched comparison group.

Setting & participants

1,285 living kidney donors from seven tertiary hospitals between 2003 and 2016, and a matched comparison group consisting of the same number of health screening examinees with similar baseline clinical characteristics and socioeconomic status. All participants were receiving Korean national health insurance.

Exposures

Kidney donation as reflected in the Korean National Health Insurance System (NHIS) database.

Outcomes

Changes in household economic status estimated by Korean national health insurance fees and changes in employment status reflected in the NHIS database.

Analytical approach

The outcomes of the donor group and matched control group were compared annually using multivariable logistic regression analyses adjusted for clinical and demographic characteristics.

Results

The median ages of the donors and matched controls were 45 and 46 years, respectively; 44.6% of both groups were male. Compared to the comparison group, living donors were at higher risk of being unemployed or losing employment during the first two years after donation [e.g., first-year loss of employment, odds ratio (OR) 2.27 (1.55–3.33)]; however, this association did not persist. Donors also had a significantly lower odds of improvement in economic status [OR 0.57 (0.47–0.71)] and a higher odds of deterioration in financial status [OR 1.54 (1.23–1.93)] in the first year following transplantation and subsequently.

Limitations

Unmeasured differences between donors and matched controls creating residual selection bias and confounding.

Conclusions

Living kidney donors may suffer loss of employment and poor economic status after their voluntary donation. The socioeconomic impact on these donors should be considered in conjunction with the potential long-term adverse health outcomes following donation.