Live donor study – implications of kidney donation on cardiovascular risk with a focus on lipid parameters including lipoprotein a

Abstract

Ph 0404834705 SUPPORT AND FINANCIAL DISCLOSURE DECLARATIONCarmel Hawley has no conflicts to declare.Brian Doucet has no conflicts to declare.Nicole Isbel has no conflicts to declare.Karam Kostner has no conflicts to declare.Omar Kaiser has no conflicts to declare.This article is protected by copyright. All rights reserved. AbstractIn this prospective observational cohort study we evaluate the change in cardiovascular risk parameters, with a focus on lipids, in live kidney donors one year post donation. Body mass index (BMI), systolic/diastolic blood pressure, kidney function (51 Cr-EDTA eGFR), and lipid parameters were measured at baseline and one year. Data on 87 live kidney donors was collected. BMI increased from 26.5 ± 2.7 pre to 27.4 ± 3.0 kg/m 2 post donation (p<0.0001).51 Cr-EDTA eGFR decreased from 111.8 ± 20.0 pre to 72.1 ± 13.1 ml/min/1.

A prospective controlled study of metabolic and physiologic effects of kidney donation suggests that donors retain stable kidney function over the first nine years

“…Theoretically, lipoprotein metabolism could be affected by reduced GFR in donors and thereby increase the risk for cardiovascular disease. 17 However, we found no differences in serum lipoprotein levels between donors and controls over the 9-year follow-up period. Likewise, it has been suggested that reduced kidney function in donors could lead to alterations resulting in an increased risk for metabolic syndrome.…”

Non-genetic influences on lipoprotein(a) concentrations

“…For example, in the Modification of Diet in Renal Disease Study enrolled 804 patients with CKD (stages 3–4 with a GFR range of 13–55 mL/min/1.73 m 2 ), Lp(a) level was not associated with GFR [ 130 ]. Among kidney donors whose GFR was reduced by ~36% at 1 year post donation versus before donation, Lp(a) was not changed [ 131 ].…”

The role of lipoprotein (a) in chronic kidney disease

“…For example, there was no significant association between Lp(a) and GFR in 804 individuals with stage 3–4 CKD (with GFR ranging from 13 to 55 ml/min/1.73 m 2 ) and no suggestion of an interaction with apo(a) isoform size ( 28 ). In addition, a study of 87 kidney donors whose average kidney function was reduced from an eGFR of 112 before donation to 72 ml/min/1.73 m 2 1 year later, showed no significant difference in Lp(a) as a result of donation (18 mg/dl before donation versus 19 mg/dl 1 year after donation, P = 0.07), albeit apo(a) isoform size was not available to examine associations specifically in those with large apo(a) isoforms ( 29 ).…”