Central Body Fat Distribution and Kidney Function after Living Kidney Donation

Author:

Westenberg Lisa B.12ORCID,Pol Robert A.2ORCID,van der Weijden Jessica1ORCID,de Borst Martin H.1ORCID,Bakker Stephan J.L.1ORCID,van Londen Marco1ORCID,

Affiliation:

1. Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

2. Division of Transplant Surgery, Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

Abstract

Background In most screening guidelines, high body mass index (BMI) is considered a contraindication for kidney donation. New insights suggest that central body fat distribution might provide greater power in assessing kidney risk. This study aimed to determine whether BMI and central body fat distribution measures are associated with long-term kidney function after donor nephrectomy. We hypothesized that higher BMI, waist circumference (WC), and waist-to-height ratio (WHtR) were associated with lower kidney function long term after donation. Methods The study population consisted of living kidney donors. BMI, WC, and WHtR were measured during donor screening. The outcome postdonation kidney function was assessed using measured GFR (mGFR) (mGFR, 125I-iothalamate infusion) at 3 months (n=1042), 5 years (n=556), and 10 years (n=210) of follow-up. Primary multivariable linear regression analyses were performed with BMI and WC and secondary analyses with WHtR. Linear mixed models were performed to investigate change in postdonation eGFR. Results The donor age was 52±11 years, and 48% were male. The mean BMI was 26.1±3.6 kg/m2, and WC was 91±11 cm. Higher predonation BMI was associated with lower mGFR throughout follow-up: −1.35 (95% confidence interval [CI], −1.95 to −0.80), −1.55 (95% CI, −2.50 to −0.65), and −2.35 (95% CI, −4.10 to −0.60) ml/min per m2 per 5 kg/m2 higher BMI at 3 months, 5, and 10 years after donation, respectively, adjusted for sex, age, and predonation GFR. For WC, differences in mGFR were −1.30 (95% CI, −1.70 to −0.90), −1.50 (95% CI, −2.20 to −0.80), and −1.70 (95% CI, −3.00 to −0.50) ml/min per m2 per 10 cm higher WC at 3 months, 5, and 10 years after donation, respectively. In male donors, BMI and WC were significantly associated with a negative postdonation change in eGFR. Conclusions Higher BMI and WC were independently associated with lower GFR (long term) after living kidney donation.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Central Body Fat Distribution Research and Kidney Function;Clinical Journal of the American Society of Nephrology;2024-04

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