Purpose <p>This study aimed to assess the impact of kidney donation and pre-donation factors such as age and BMI, are associated with long-term outcomes like hypertension, diabetes and GFR decline. highlighting the importance of proper donor selection and long-term follow up.</p> Methods <p>This study aims to assess long-term clinical outcomes, such as the development of hypertension, diabetes, proteinuria, and changes in kidney function, in living kidney donors following nephrectomy.</p> Results <p>A cohort of 87 kidney donors from Erciyes University and a control group of 100 individuals with comparable demographics were monitored. Parameters such as blood pressure, BMI, GFR, and proteinuria levels were documented pre- and post-donation, and outcomes were compared within and between groups.</p> Conclusion <p>Multiple regression analysis revealed nephrectomy as an independent risk factor for increased hypertension incidence (p = 0.002) and a persistent reduction in GFR exceeding 20% (p &lt; 0.001). Advanced age at donation and post-donation BMI were associated with elevated risks of hypertension and diabetes.</p>