TY - JOUR
T1 - Central Body Fat Distribution and Kidney Function after Living Kidney Donation
AU - TransplantLines Investigators
AU - Westenberg, Lisa B
AU - Pol, Robert A
AU - van der Weijden, Jessica
AU - de Borst, Martin H
AU - Bakker, Stephan J L
AU - van Londen, Marco
N1 - Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Nephrology.
PY - 2024/4
Y1 - 2024/4
N2 - 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 if BMI and central body fat distribution measures are associated with long-term kidney function after donor nephrectomy. We hypothesized that higher BMI, waist circumference, and waist-to-height ratio were associated with lower kidney function long-term after donation.METHODS: The study population consisted of living kidney donors. BMI, waist circumference, and waist-to-height ratio were measured during donor screening. The outcome post-donation kidney function was assessed using measured glomerular filtration rate (measured GFR, 125I-Iothalamate infusion) at 3 months (n=1042), 5 years (n=556) and 10 years (n=210) follow-up. Primary multivariable linear regression analyses were performed with BMI and waist circumference; secondary analyses with waist-to-height ratio. Linear mixed models were performed to investigate change in post-donation estimated GFR.RESULTS: Donor age was 52±11 years, and 48% were male. Mean BMI was 26.1±3.6 kg/m2 and waist circumference was 91±11 cm. Higher pre-donation BMI was associated with lower measured GFR throughout follow-up: -1.35 (95% CI -1.95; -0.80), -1.55 (95% CI -2.50; -0.65), and -2.35 (95% CI -4.10; -0.60) mL/min/m2 per 5 kg/m2 higher BMI at 3 months, 5 years, and 10 years after donation, respectively, adjusted for sex, age, and pre-donation GFR. For waist circumference, differences in measured GFR were -1.30 (95% CI -1.70; -0.90), -1.50 (95% CI -2.20; -0.80), and -1.70 (95% CI -3.00- -0.50) mL/min/m2 per 10 cm higher waist circumference at 3 months, 5 years, and 10 years after donation, respectively. In male donors, BMI and waist circumference were significantly associated with a negative post-donation change in estimated GFR.CONCLUSIONS: Higher BMI and waist circumference were independently associated with lower GFR (long-term) after living kidney donation.
AB - 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 if BMI and central body fat distribution measures are associated with long-term kidney function after donor nephrectomy. We hypothesized that higher BMI, waist circumference, and waist-to-height ratio were associated with lower kidney function long-term after donation.METHODS: The study population consisted of living kidney donors. BMI, waist circumference, and waist-to-height ratio were measured during donor screening. The outcome post-donation kidney function was assessed using measured glomerular filtration rate (measured GFR, 125I-Iothalamate infusion) at 3 months (n=1042), 5 years (n=556) and 10 years (n=210) follow-up. Primary multivariable linear regression analyses were performed with BMI and waist circumference; secondary analyses with waist-to-height ratio. Linear mixed models were performed to investigate change in post-donation estimated GFR.RESULTS: Donor age was 52±11 years, and 48% were male. Mean BMI was 26.1±3.6 kg/m2 and waist circumference was 91±11 cm. Higher pre-donation BMI was associated with lower measured GFR throughout follow-up: -1.35 (95% CI -1.95; -0.80), -1.55 (95% CI -2.50; -0.65), and -2.35 (95% CI -4.10; -0.60) mL/min/m2 per 5 kg/m2 higher BMI at 3 months, 5 years, and 10 years after donation, respectively, adjusted for sex, age, and pre-donation GFR. For waist circumference, differences in measured GFR were -1.30 (95% CI -1.70; -0.90), -1.50 (95% CI -2.20; -0.80), and -1.70 (95% CI -3.00- -0.50) mL/min/m2 per 10 cm higher waist circumference at 3 months, 5 years, and 10 years after donation, respectively. In male donors, BMI and waist circumference were significantly associated with a negative post-donation change in estimated GFR.CONCLUSIONS: Higher BMI and waist circumference were independently associated with lower GFR (long-term) after living kidney donation.
UR - http://www.scopus.com/inward/record.url?scp=85190482098&partnerID=8YFLogxK
U2 - 10.2215/CJN.0000000000000403
DO - 10.2215/CJN.0000000000000403
M3 - Article
C2 - 38190119
SN - 1555-9041
VL - 19
SP - 503
EP - 513
JO - Clinical journal of the American Society of Nephrology : CJASN
JF - Clinical journal of the American Society of Nephrology : CJASN
IS - 4
ER -