TOPLINE

Nearly all living kidney donors reported normal-to-high self-esteem before donation and maintained this level throughout 5 years of follow-up, with only 2%-4% experiencing low self-esteem at any point. Donors with lower baseline self-esteem experienced a modest increase in self-esteem after donation, and improvements in self-esteem were associated with concurrent reductions in symptoms of depression and anxiety.

METHODOLOGY

• Researchers conducted a prospective cohort study of 941 living kidney donors enrolled before donation from 12 Canadian and 5 Australian transplant centers (mean age at study recruitment, 47 years; 66% women).
• Self-esteem was measured using the Rosenberg Self-Esteem Scale (RSES) before donation, 3 months after donation, and then annually for 5 years or until the last follow-up visit, with possible scores ranging from 0-30 and higher scores indicating higher self-esteem.
• Participants also completed the Beck Depression and Anxiety Inventories at these timepoints to assess mental health symptoms.
• Statistical models were used to examine whether pre-donation characteristics were associated with lower self-esteem after donation and whether changes in self-esteem were associated with changes in symptoms of depression and anxiety.

TAKEAWAY

• Over 95% of donors maintained normal-to-high self-esteem throughout follow-up. On average, donors experienced less than a 1-point decrease in self-esteem between pre-donation and follow-up measurements; while these changes were statistically significant, they were not clinically meaningful.
• Donors with RSES scores ≤ 20 before donation had an approximate 2-point increase in self-esteem during follow-up (P < .001).
• More symptoms of depression before donation were associated with lower self-esteem scores 3 months after donation (P = .006).
• An increase in self-esteem scores before donation to 3 months after donation was associated with concurrent reductions in symptoms of depression and anxiety (P < .001).

IN PRACTICE

"Living kidney donation has a minimal impact on donors' self-esteem, even among those who reported lower self-esteem before donation," wrote the authors.

SOURCE

The study was led by Ruth Neumann MD, Division of Nephrology, Department of Medicine, Western University in London, Ontario, Canada. It was published online on August 24 in American Journal of Kidney Diseases.

LIMITATIONS

Despite repeated follow-up attempts, self-esteem data were missing for a notable proportion of donors. The study did not assess whether early recipient graft failure, death, or a strained donor-recipient relationship affected donor self-esteem or mental health. Finally, socioeconomic status was measured using different indices for Canadian versus Australian donors. 

DISCLOSURES

The study was funded by the Canadian Institutes of Health Research with partnership funding from Astellas Canada and Novartis. Some authors reported academic chair or salary-award support, and some disclosed industry ties, including research grants, consulting fees, or speaker honoraria from pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.