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Samenvatting

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.

Originele taal-2English
Pagina's (van-tot)503-513
Aantal pagina's11
TijdschriftClinical journal of the American Society of Nephrology : CJASN
Volume19
Nummer van het tijdschrift4
Vroegere onlinedatum8-jan.-2024
DOI's
StatusPublished - apr.-2024

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