Renal failure hits 15% organ donors of Tsunami Colony

Chennai: Nearly 15% of commercial organ donors from the Tsunami Colony in Chennai screened by doctors at the Rajiv Gandhi Government General Hospital were found to have developed chronic renal failure 10 to 20 days after they underwent the surgery, a study has shown.A cross-sectional study on a cluster of 54 donors from the same geographical area by doctors at the RGGH showed all of them received financial compensation for the donation. Most of the donors 52 of them were women, and the median age of patients at the time of surgery was 31. Seven of them were between 31 to 40 years, 31 were between 41 and 50 and 16 were between 51 and 60 years of age. Only 46% of the patients had post-surgery follow-up visits.

An analysis showed eight people in the group developed chronic kidney disease. To diagnose this, doctors calculated the eGFR (estimated glomerular filtration rate) which is a measure of how well the kidneys are working. The calculation for eGFR is done based on the results of blood tests, age, sex, and body type.Based on the eGFR count, seven people in the group were found to have stage 3 of chronic kidney disease, said Sumathi Govindaraju, the first author of the study which was recently presented at a medical conference in Pune. In this stage, doctors may have seen protein in the urine samples indicating kidneys have damage that affects how well they work. “This damage normally is not reversible, but medicines and lifestyle changes can slow further kidney damage,” she said. While it can be asymptomatic, many may feel weak and tired. People complain of swelling in the hands or feet, dry or itchy skin, lower back pain, muscle cramps, sleep issues, and foamy dark urine.One person had stage 4 disease, which means that the kidneys are moderately or severely damaged and are not working as well as they should to filter waste from the blood, Dr Govindaraju said. Waste products may build up in the blood and cause other health problems. It can lead to anaemia, bone disease, heart disease, high potassium, high phosphorus, and metabolic acidosis. “These patients may require medical intervention and nephrologists may decide on the need for dialysis and organ transplants,” he said.Senior nephrologist and Transtan member secretary Dr N Gopalakrishnan said individuals undergoing donor nephrectomy must be made aware of the small, but significant long-term risk of hypertension and chronic kidney disease. One person had hypertension before donor transplant, but over time 33% of them have diabetes, 26% have hypertension and 70% are obese, he said. Kidney transplantation is an ideal form of renal replacement therapy for patients with end-stage kidney disease, he said. With growing numbers of patients with chronic kidney disease, the demand for organs is also increasing. “Commercial organ donation is illegal in India. We encourage blood relatives and spouses to donate organs if the patient cannot wait for a cadaver transplant. It is important to follow up on both donor and recipient health post-transplant,” he said.
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