Dear Dr. Kirk,
We read with interest the article by Cherikh et al. (1) demonstrating no increase in risk of end-stage renal disease (ESRD) following living kidney donation. This important study validates current clinical practices in live kidney donation.
Child-to-parent donation occurs nearly three times more often among African American kidney donors at our center, compared to European American (2). Although the total number of child-to-parent donors with subsequent ESRD in the Cherikh et al. study was relatively low (n = 21), we would find it useful if age- and race-specific data were provided for this outcome. If child-to-parent kidney donation is more common in African Americans throughout the United States and ESRD disproportionately developed in these younger African American donors, it might be prudent to minimize “normal for now” child-to-parent donations to reduce future ESRD (3). This information would inform readers whether a portion of the higher rates of ESRD in African American living kidney donors relates to younger age at donation before nephropathy becomes clinically apparent (4), rather than the suggested higher background rates of kidney disease in African Americans relative to European Americans; an effect which is largely because of variation in the apolipoprotein L1 gene in nondiabetic etiologies of kidney disease (5).