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An Assurance of Insurance: Should Living Kidney Donors be Required to have Health Insurance?

Background: The aims of the study were to examine if living donors followed the recommended UNOS medical visits postsurgery examinations and to assess if medical outcomes after donating a kidney were different by insurance status. 
Methods: Data was collected from the medical records of 680 consecutive living kidney donors between January 2010 and June 2015. 
Results: Significant predictors of having health insurance included higher levels of education (p=0.007) and being married (p=0.031). Post-surgical visits were lower for those without insurance at six months (43% versus 77%; p=0.029) and one year (35% versus 77%, p<0.001) than those with insurance. A robust trend was observed whereas lack of health insurance was predictive of higher systolic blood pressure (p=0.05). Significant predictors of higher systolic blood pressure included being older (p<0.001), male (p<0.001); and non-Caucasian (p=0.012). Significant predictors of higher diastolic blood pressure were being male (p<0.001) and non- Caucasian (p=0.020); and prior drug use (p=0.003). 
Conclusion: Development of interventions to improve postsurgical follow up for kidney donors without insurance is warranted to potentially reduce poor health outcomes such as hypertension post kidney donation.