Changes in Body Weight Before and After Kidney Donation

Bugeja, Ann; Harris, Sophie; Ernst, Jaclyn; Burns, Kevin D.; Knoll, Greg

doi:10.1177/2054358119847203

Cited by 11 publications

(7 citation statements)

References 12 publications

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“…Our study describes the temporal trends in living kidney donor BMI from initial assessment to two-year postdonation. Although weight gain in the living kidney donor population as a whole has been previously reported by Issa et al [17] and Bugeja et al [18], the main strength of our study is that it clearly demonstrated an initial weight loss from predonation counselling to donation, suggesting that most obese donors are appropriately motivated to lose weight in order to proceed with donation. Although Issa et al [17] report that 12% of obese donors switch to overweight group prior to donation, they do not explain why these trends are observed.…”

Section: Discussionsupporting

confidence: 62%

Weight trends in living kidney donors suggest predonation counselling alone lacks a sustainable effect on weight loss: a single centre cohort study

et al. 2021

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Summary Living kidney donors are at risk of long‐term end‐stage renal disease, and obesity is an independent risk factor. In our centre, predonation counselling of obese donors concentrates on lifestyle modifications, particularly weight loss and exercise. Whether these recommendations have a sustainable effect after donation remains unknown. We conducted a retrospective analysis of all donors who proceeded to donation between 2012 and 2016. Donors’ body mass index (BMI) was compared between predefined time points using matched pair analysis. Among 303 donors included, 15% were obese at initial assessment. Obese donors were observed to lose weight by the time of donation (mean BMI difference 1.32 kg/m2, P < 0.001), but bounced back to their initial weight at one‐year postdonation (mean BMI difference + 1.47 kg/m2, P < 0.001), which was maintained at two‐year postdonation. While 71% of obese donors lost weight by the time of donation, 56% of them gained that weight back at one year. Our findings underline the success of predonation counselling on lifestyle modification in highly motivated obese donors, although additional strategies are required to sustain weight loss. The impact of weight gain on long‐term risk needs further evaluation. Living donor programmes should provide continued support with lifestyle modifications after donation.

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Section: Discussionsupporting

confidence: 62%

Weight trends in living kidney donors suggest predonation counselling alone lacks a sustainable effect on weight loss: a single centre cohort study

et al. 2021

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“…Prior data show that overweight and obese donors experience significant weight gain after donation, 33 which is a risk factor for subsequent diabetes and hypertension. 34 The incidence of nonalcoholic fatty liver disease (NAFLD) is increasing, concurrent with rising rates of obesity, hypertension, diabetes, and The impact of various isolated cardiac abnormalities detected on echocardiography or electrocardiogram on long-term outcomes in the donors, if any, is not known. Our survey is the first to document the heterogeneity in practices when these are incidentally found in the otherwise asymptomatic donor candidates.…”

Section: Discussionmentioning

confidence: 99%

“…The findings from our survey that significantly fewer programs are considering candidates with BMI >40 now than in the past are in line with these observations regarding the long‐term risks associated with donor obesity. Prior data show that overweight and obese donors experience significant weight gain after donation, 33 which is a risk factor for subsequent diabetes and hypertension 34 …”

Section: Discussionmentioning

confidence: 99%

Metabolic, cardiovascular, and substance use evaluation of living kidney donor candidates: US practices in 2017

Garg

Lentine

Inker

et al. 2020

American Journal of Transplantation

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We surveyed US transplant centers to assess practices regarding the evaluation and selection of living kidney donors based on metabolic, cardiovascular, and substance use risk factors. Our companion article describes renal aspects of the evaluation. Response rate was 31%. Compared with 2005, programs have become more accepting of hypertensive candidates: 65% in 2017% vs 41% in 2005 consider candidates with hypertension well controlled with 1 medication. One notable exception is black hypertensive candidates, who are frequently excluded regardless of severity. The most common body mass index (BMI) cutoff remains 35 kg/m 2 , and fewer programs now consider candidates with BMI >40 kg/m 2. A 2-hour oral glucose tolerance test of ≥140 mg/dL remains the most common criterion for exclusion of prediabetic candidates. One quarter to one third of programs exclude based on isolated cardiac abnormalities, such as mild aortic stenosis; a similar proportion consider these candidates only if older than 50 years. Cigarette or marijuana smoking are infrequently criteria for exclusion, although 45% and 37% programs, respectively, require cessation 4 weeks prior to surgery. In addition to providing an overview of current practices in living kidney donor evaluation, our study highlights the importance of research evaluating outcomes with various comorbidities to guide practice.

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“…In fact, among all donors, both obese and nonobese, weight significantly increased after kidney donation. 43…”

Section: Discussionmentioning

confidence: 99%

Bariatric Surgery in Severely Obese Kidney Donors Before Kidney Transplantation: A Retrospective Study

Bielopolski,

Yemini,

Gravetz

et al. 2023

Transplantation

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Background. Bariatric surgery (BS) is the optimal approach for sustained weight loss and may alter donation candidacy in potential donors with obesity. We evaluated the long-term effects of nephrectomy after BS on metabolic profile, including body mass index, serum lipids and diabetes, and kidney function of donors. Methods. This was a single-center retrospective study. Live kidney donors who underwent BS before nephrectomy were matched for age, gender, and body mass index with patients who underwent BS alone and with donors who underwent nephrectomy alone. Estimated glomerular filtration rate (eGFR) was calculated according to Chronic Kidney Disease Epidemiology Collaboration and adjusted to individual body surface area to create absolute eGFR. Results. Twenty-three patients who underwent BS before kidney donation were matched to 46 controls who underwent BS alone. At the last follow-up, the study group showed significantly worse lipid profile with low-density lipoprotein of 115 ± 25 mg/dL versus the control group with low-density lipoprotein of 99 ± 29 mg/dL (P = 0.036) and mean total cholesterol of 191 ± 32 versus 174 ± 33 mg/dL (P = 0.046). The second control group of matched nonobese kidney donors (n = 72) had similar serum creatinine, eGFR, and absolute eGFR as the study group before nephrectomy and 1 y after the procedure. At the end of follow-up, the study group had significantly higher absolute eGFR compared with the control group (86 ± 21 versus 76 ± 18 mL/min; P = 0.02) and similar serum creatinine and eGFR. Conclusions. BS before live kidney donation is a safe procedure that could increase the donor pool and improve their health in the long run. Donors should be encouraged to maintain their weight and avoid adverse lipid profile and hyperfiltration.

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Changes in Body Weight Before and After Kidney Donation

Cited by 11 publications

References 12 publications

Weight trends in living kidney donors suggest predonation counselling alone lacks a sustainable effect on weight loss: a single centre cohort study

Weight trends in living kidney donors suggest predonation counselling alone lacks a sustainable effect on weight loss: a single centre cohort study

Metabolic, cardiovascular, and substance use evaluation of living kidney donor candidates: US practices in 2017

Bariatric Surgery in Severely Obese Kidney Donors Before Kidney Transplantation: A Retrospective Study

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