Weight gain after kidney donation: Association with increased risks of type 2 diabetes and hypertension

Issa, Naim; Sánchez, Otto A.; Kukla, Aleksandra; Riad, Samy; Berglund, Danielle; Ibrahim, Hassan N.; Matas, Arthur J.

doi:10.1111/ctr.13360

Cited by 21 publications

(20 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our subgroup analysis of donors who also had BMI data at the 1‐year post‐donation anniversary, compared with stable BMI, BMI increase >0.5 kg/m 2 by year 1 was associated with increased risk of subsequent ADM use. This is consistent with recent data that post‐donation weight gain is associated with higher risk of diabetes . Although prospective evaluations of dietary interventions and monitored exercise programs in donors are needed to advance effective care, donor candidates should be counseled on lifestyle interventions to support achievement and maintenance of healthy body weight, and regular exercise according to guidelines for the general population .…”

Section: Discussionsupporting

confidence: 86%

Associations of obesity with antidiabetic medication use after living kidney donation: An analysis of linked national registry and pharmacy fill records

Lentine

Koraishy

Sarabu

et al. 2019

Clinical Transplantation

View full text Add to dashboard Cite

We examined a novel linkage of national US donor registry data with records from a pharmacy claims warehouse (2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016) to examine associations (adjusted hazard ratio, LCL aHR UCL ) of post-donation fills of antidiabetic medications (ADM, insulin or non-insulin agents) with body mass index (BMI) at donation and other demographic and clinical factors. In 28 515 living kidney donors (LKDs), incidence of ADM use at 9 years rose in a graded manner with higher baseline BMI: underweight, 0.9%; normal weight, 2.1%; overweight, 3.5%; obese, 8.5%. Obesity was associated with higher risk of ADM use compared with normal BMI (aHR, 3.36 4.59 6.27 ). Metformin was the most commonly used ADM and was filled more often by obese than by normal weight donors (9-year incidence, 6.87% vs 1.85%, aHR, 3.55 5.00 7.04 ). Insulin use was uncommon and did not differ significantly by BMI. Among a subgroup with BMI data at the 1-year post-donation anniversary (n = 19 528), compared with stable BMI, BMI increase >0.5 kg/m 2 by year 1 was associated with increased risk of subsequent ADM use (aHR, 1.03 1.48 2.14, P = .04). While this study did not assess the impact of donation on the development of obesity, these data support that among LKD, obesity is a strong correlate of ADM use.

show abstract

Section: Discussionsupporting

confidence: 86%

Associations of obesity with antidiabetic medication use after living kidney donation: An analysis of linked national registry and pharmacy fill records

Lentine

Koraishy

Sarabu

et al. 2019

Clinical Transplantation

View full text Add to dashboard Cite

show abstract

“…Furthermore, weight gain after kidney donation was associated with an increased risk of type 2 diabetes and hypertension. 10 In 2014, 20% of Canada’s general population self-reported a height and a weight that placed them in the obese category, up from approximately 15% in 2003. 11 In our study, the proportion of kidney donors with obesity at the time of kidney donation was higher at 30%.…”

Section: Discussionmentioning

confidence: 99%

Changes in Body Weight Before and After Kidney Donation

Bugeja

Harris

Ernst

et al. 2019

Can J Kidney Health Dis

View full text Add to dashboard Cite

Background: Living kidney donors remain at low risk of end-stage kidney disease (ESKD), but the risk for obese and overweight donors is increased. The Kidney Disease Improving Global Outcomes (KDIGO) clinical guideline recommends that overweight and obese patients pursue weight loss before donation and maintain a healthy post-donation weight. Objective: To determine the trajectory of weight changes before and after living kidney donation. Design: Retrospective cohort study. Setting: The Living Kidney Donor program in the Champlain Local Health Integration Network at The Ottawa Hospital in Ottawa, Canada. Patients: The study included 151 living kidney donors who donated between January 2009 and December 2017. Measurements: Date of kidney donation, relationship to the transplant recipient, and cause of ESKD in the transplant recipient were documented. Demographic data, markers of glycemic control, and weights at the time of clinic visits were recorded. Methods: The analysis included use of paired Student’s t tests to compare mean differences in weight at kidney donation relative to the time of initial assessment and at last follow-up. Results: The median (interquartile range [IQR]) follow-up was 392 (362, 1096) days post-donation. Among donors with normal body mass index (BMI; 18.5-24.9 kg/m 2 ), weight loss occurred before donation (62.8 ± 3.1 kg to 61.5 kg ± 2.9 kg; mean difference 1.1 ± 2.7 kg, P < .01) and did not change significantly post-donation. Among overweight/obese donors (BMI ≥25 kg/m 2 ), weight did not change significantly pre-donation, but increased significantly post-donation (86.0 ± 2.1 kg to 88.8 ± 2.7 kg; mean difference 2.3 ± 0.9 kg, P < .0001). Limitations: The single-center design of the study limits generalizability. Conclusions: Donors with normal BMI experienced significant weight loss before donation and maintained healthy body weight post-donation. Conversely, donors with BMI ≥25 kg/m 2 at donation experienced significant weight gain over 1-year post-donation. Our findings suggest the need for enhanced weight control efforts among obese and overweight kidney donors to reduce the risk of ESKD.

show abstract

“…dyslipidemia 35. Although donor candidates with severe hypertension and diabetes are routinely excluded, we presume transplant programs are encountering hepatic steatosis more frequently in this population (eg, as an incidental finding on abdominal imaging).…”

mentioning

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

View full text Add to dashboard Cite

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.

show abstract

Weight gain after kidney donation: Association with increased risks of type 2 diabetes and hypertension

Cited by 21 publications

References 19 publications

Associations of obesity with antidiabetic medication use after living kidney donation: An analysis of linked national registry and pharmacy fill records

Associations of obesity with antidiabetic medication use after living kidney donation: An analysis of linked national registry and pharmacy fill records

Changes in Body Weight Before and After Kidney Donation

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

Contact Info

Product

Resources

About