Hypertension Risk and Kidney Function Following Kidney Donation—Reply

In Reply We appreciate the comments provided by Drs Lin and Huang. In theory, randomized trials could generate unbiased estimates of donor risk; however, randomized trials of living kidney donation are not ethically feasible. The best possible approach is to conduct a multicenter prospective cohort study that enrolls donors and nondonors with similar indicators of baseline health and follows them with minimal loss to follow-up for outcomes. We conducted such a study to produce estimates of kidney donation–attributable risk with a low risk of bias, achieving the highest score for methodological quality on the Newcastle-Ottawa Scale.