Literature DB >> 19443625

Long-term renal function and cardiovascular disease risk in obese kidney donors.

Mohammad M Tavakol1, Flavio G Vincenti, Hamid Assadi, Michael J Frederick, Stephen J Tomlanovich, John P Roberts, Andrew M Posselt.   

Abstract

BACKGROUND AND OBJECTIVES: Increasing demand for live-donor kidneys has encouraged the use of obese donors despite the absence of long-term outcome data and evidence that obesity can adversely affect renal function. We wished to determine whether obesity increased the risk for renal dysfunction and other medical comorbidities in donors several years after donation. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Ninety-eight patients who donated a kidney 5 to 40 years previously were stratified according to body mass index (BMI) at donation and evaluated for renal dysfunction and risk factors for cardiovascular disease. Patients who were from the 2005 through 2006 National Health and Nutrition Examination Survey database; did not have renal disease; and were matched for age, gender, race, and BMI served as two-kidney control subjects.
RESULTS: Renal function in obese (BMI > or =30) and nonobese (BMI <30) donors was similar, and both donor groups had reduced renal function compared with BMI-matched two-kidney control subjects. Obesity was associated with more hypertension and dyslipidemias in both donors and two-kidney control subjects; however, there were no significant differences between the two groups within each BMI category.
CONCLUSIONS: These results indicate that obese donors are not at higher risk for long-term reduced renal function compared with nonobese donors and that the increased incidence of hypertension and other cardiovascular disease risk factors in obese donors is due to their obesity and is not further exacerbated by nephrectomy. These findings support the current practice of using otherwise healthy overweight and obese donors but emphasize the need for more intensive preoperative education and postoperative health care maintenance in this donor group.

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Mesh:

Year:  2009        PMID: 19443625      PMCID: PMC2709512          DOI: 10.2215/CJN.01350209

Source DB:  PubMed          Journal:  Clin J Am Soc Nephrol        ISSN: 1555-9041            Impact factor:   8.237


  42 in total

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Authors:  B F Culleton; M G Larson; P W Wilson; J C Evans; P S Parfrey; D Levy
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2.  Long-term (20-37 years) follow-up of living kidney donors.

Authors:  Thiagarajan Ramcharan; Arthur J Matas
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3.  Renal insufficiency as a predictor of cardiovascular outcomes and the impact of ramipril: the HOPE randomized trial.

Authors:  J F Mann; H C Gerstein; J Pogue; J Bosch; S Yusuf
Journal:  Ann Intern Med       Date:  2001-04-17       Impact factor: 25.391

Review 4.  The kidney, hypertension, and obesity.

Authors:  John E Hall
Journal:  Hypertension       Date:  2003-01-20       Impact factor: 10.190

5.  Renal outcome 25 years after donor nephrectomy.

Authors:  D A Goldfarb; S F Matin; W E Braun; M J Schreiber; B Mastroianni; D Papajcik; H A Rolin; S Flechner; M Goormastic; A C Novick
Journal:  J Urol       Date:  2001-12       Impact factor: 7.450

6.  High-normal serum creatinine concentration is a predictor of cardiovascular risk in essential hypertension.

Authors:  G Schillaci; G Reboldi; P Verdecchia
Journal:  Arch Intern Med       Date:  2001-03-26

7.  Laparoscopic nephrectomy in the markedly obese living renal donor.

Authors:  S C Jacobs; E Cho; B J Dunkin; S T Bartlett; J L Flowers; B Jarrell; S C Jacobs
Journal:  Urology       Date:  2000-12-20       Impact factor: 2.649

Review 8.  Obesity and target organ damage: the kidney.

Authors:  P E de Jong; J C Verhave; S J Pinto-Sietsma; H L Hillege
Journal:  Int J Obes Relat Metab Disord       Date:  2002-12

9.  Obesity in adulthood and its consequences for life expectancy: a life-table analysis.

Authors:  Anna Peeters; Jan J Barendregt; Frans Willekens; Johan P Mackenbach; Abdullah Al Mamun; Luc Bonneux
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10.  Obesity and the risk of heart failure.

Authors:  Satish Kenchaiah; Jane C Evans; Daniel Levy; Peter W F Wilson; Emelia J Benjamin; Martin G Larson; William B Kannel; Ramachandran S Vasan
Journal:  N Engl J Med       Date:  2002-08-01       Impact factor: 91.245

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  16 in total

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Authors:  Ajay Kher; Didier A Mandelbrot
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2.  Barriers to living donor kidney transplantation among black or older transplant candidates.

Authors:  Francis L Weng; Peter P Reese; Shamkant Mulgaonkar; Anup M Patel
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3.  Living donor evaluation and exclusion: the Stanford experience.

Authors:  Jessica B Lapasia; Soo-yee Kong; Stephan Busque; John D Scandling; Glenn M Chertow; Jane C Tan
Journal:  Clin Transplant       Date:  2010-11-02       Impact factor: 2.863

4.  Weight trends in United States living kidney donors: Analysis of the UNOS database.

Authors:  Mala Sachdeva; Lisa M Rosen; Jeny Varghese; Steven Fishbane; Ernesto P Molmenti
Journal:  World J Transplant       Date:  2015-09-24

5.  Obesity Correlates With Glomerulomegaly But Is Not Associated With Kidney Dysfunction Early After Donation.

Authors:  Harini A Chakkera; Yu-Hui H Chang; Leslie F Thomas; Ramesh T Avula; Hatem Amer; Lilach O Lerman; Aleksandar Denic; Andrew D Rule
Journal:  Transplant Direct       Date:  2015-02-01

6.  Choosing the order of deceased donor and living donor kidney transplantation in pediatric recipients: a Markov decision process model.

Authors:  Kyle J Van Arendonk; Eric K H Chow; Nathan T James; Babak J Orandi; Trevor A Ellison; Jodi M Smith; Paul M Colombani; And Dorry L Segev
Journal:  Transplantation       Date:  2015-02       Impact factor: 4.939

Review 7.  Obesity and metabolic syndrome in kidney transplantation.

Authors:  Heather LaGuardia; Rubin Zhang
Journal:  Curr Hypertens Rep       Date:  2013-06       Impact factor: 5.369

8.  The Outcomes of Living Kidney Donation from Medically Complex Donors: Implications for the Donor and the Recipient.

Authors:  Matthew Niemi; Didier A Mandelbrot
Journal:  Curr Transplant Rep       Date:  2014-03-01

9.  Manifestation of renal disease in obesity: pathophysiology of obesity-related dysfunction of the kidney.

Authors:  John A D'Elia; Bijan Roshan; Manish Maski; Larry A Weinrauch
Journal:  Int J Nephrol Renovasc Dis       Date:  2009-11-06

10.  Creatinine-based estimations of kidney function are unreliable in obese kidney donors.

Authors:  Nidhi Aggarwal; Anna C Porter; Ignatius Y S Tang; Bryan N Becker; Sanjeev K Akkina
Journal:  J Transplant       Date:  2012-01-19
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