TY - JOUR
T1 - Weight gain after kidney donation
T2 - Association with increased risks of type 2 diabetes and hypertension
AU - Issa, Naim
AU - Sánchez, Otto A.
AU - Kukla, Aleksandra
AU - Riad, Samy M.
AU - Berglund, Danielle M.
AU - Ibrahim, Hassan N.
AU - Matas, Arthur J.
N1 - Funding Information:
Parts of these analyses were presented in a poster form at the 2013 American Transplant Congress in Seattle, WA, USA. We would like to thank Mary Knattarud, PhD., for her editorial assistance, as well as the staff of the Transplant and Information Services (TIS) at the University of Minnesota for their dedication to maintaining the living kidney donors? database and for providing the information for this research work.
Publisher Copyright:
© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2018/9
Y1 - 2018/9
N2 - In the general population, obesity is associated with an increased risk of developing hypertension (HTN), type 2 diabetes mellitus (DM), and end-stage renal disease (ESRD). Therefore, most transplant centers have a body mass index (BMI) threshold for accepting living kidney donors. But there have been no studies of postdonation weight gain trends and any associated risks. We tracked serial BMIs in 940 donors for a median (IQ range) follow-up of 22.3 (15.4-35.8) years. We studied the impact of postdonation weight gain in a model adjusted for family history of HTN or DM. Donor characteristics included age, sex, smoking, fasting blood glucose, eGFR, systolic and diastolic BP, and BMI at time of donation and time postdonation. Postdonation weight gain was associated with a significant increase in the relative risk of developing HTN RR 1.93 (95% CI 1.51-2.46) (P < 0.001) and/or DM RR 4.18 (95% CI 2.05-8.5) (P < 0.0001), but not (to date) cardiovascular disease (CVD), reduced eGFR or death. Like the general population, donors gained weight as they aged; a higher BMI was associated with higher incidence of DM and HTN. Postdonation care should include ongoing counseling on the risks of substantial weight gain.
AB - In the general population, obesity is associated with an increased risk of developing hypertension (HTN), type 2 diabetes mellitus (DM), and end-stage renal disease (ESRD). Therefore, most transplant centers have a body mass index (BMI) threshold for accepting living kidney donors. But there have been no studies of postdonation weight gain trends and any associated risks. We tracked serial BMIs in 940 donors for a median (IQ range) follow-up of 22.3 (15.4-35.8) years. We studied the impact of postdonation weight gain in a model adjusted for family history of HTN or DM. Donor characteristics included age, sex, smoking, fasting blood glucose, eGFR, systolic and diastolic BP, and BMI at time of donation and time postdonation. Postdonation weight gain was associated with a significant increase in the relative risk of developing HTN RR 1.93 (95% CI 1.51-2.46) (P < 0.001) and/or DM RR 4.18 (95% CI 2.05-8.5) (P < 0.0001), but not (to date) cardiovascular disease (CVD), reduced eGFR or death. Like the general population, donors gained weight as they aged; a higher BMI was associated with higher incidence of DM and HTN. Postdonation care should include ongoing counseling on the risks of substantial weight gain.
KW - Living kidney donation
KW - body mass index
KW - diabetes mellitus
KW - hypertension
KW - long-term risk
KW - obesity
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U2 - 10.1111/ctr.13360
DO - 10.1111/ctr.13360
M3 - Article
C2 - 30053320
AN - SCOPUS:85052487012
VL - 32
JO - Clinical Transplantation
JF - Clinical Transplantation
SN - 0902-0063
IS - 9
M1 - e13360
ER -