Central Body Fat Distribution and Kidney Function after Living Kidney Donation
Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Nephrology..
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 whether BMI and central body fat distribution measures are associated with long-term kidney function after donor nephrectomy. We hypothesized that higher BMI, waist circumference (WC), and waist-to-height ratio (WHtR) were associated with lower kidney function long term after donation.
METHODS: The study population consisted of living kidney donors. BMI, WC, and WHtR were measured during donor screening. The outcome postdonation kidney function was assessed using measured GFR (mGFR) (mGFR, 125 I-iothalamate infusion) at 3 months ( n =1042), 5 years ( n =556), and 10 years ( n =210) of follow-up. Primary multivariable linear regression analyses were performed with BMI and WC and secondary analyses with WHtR. Linear mixed models were performed to investigate change in postdonation eGFR.
RESULTS: The donor age was 52±11 years, and 48% were male. The mean BMI was 26.1±3.6 kg/m 2 , and WC was 91±11 cm. Higher predonation BMI was associated with lower mGFR throughout follow-up: -1.35 (95% confidence interval [CI], -1.95 to -0.80), -1.55 (95% CI, -2.50 to -0.65), and -2.35 (95% CI, -4.10 to -0.60) ml/min per m 2 per 5 kg/m 2 higher BMI at 3 months, 5, and 10 years after donation, respectively, adjusted for sex, age, and predonation GFR. For WC, differences in mGFR were -1.30 (95% CI, -1.70 to -0.90), -1.50 (95% CI, -2.20 to -0.80), and -1.70 (95% CI, -3.00 to -0.50) ml/min per m 2 per 10 cm higher WC at 3 months, 5, and 10 years after donation, respectively. In male donors, BMI and WC were significantly associated with a negative postdonation change in eGFR.
CONCLUSIONS: Higher BMI and WC were independently associated with lower GFR (long term) after living kidney donation.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:19 |
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| Enthalten in: |
Clinical journal of the American Society of Nephrology : CJASN - 19(2024), 4 vom: 01. Apr., Seite 503-513 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Westenberg, Lisa B [VerfasserIn] |
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| Anmerkungen: |
Date Completed 11.04.2024 Date Revised 25.04.2024 published: Print-Electronic ClinicalTrials.gov: NCT03272841 Citation Status MEDLINE |
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| doi: |
10.2215/CJN.0000000000000403 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM366807412 |
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| 100 | 1 | |a Westenberg, Lisa B |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Central Body Fat Distribution and Kidney Function after Living Kidney Donation |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Completed 11.04.2024 | ||
| 500 | |a Date Revised 25.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT03272841 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Nephrology. | ||
| 520 | |a 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 whether BMI and central body fat distribution measures are associated with long-term kidney function after donor nephrectomy. We hypothesized that higher BMI, waist circumference (WC), and waist-to-height ratio (WHtR) were associated with lower kidney function long term after donation | ||
| 520 | |a METHODS: The study population consisted of living kidney donors. BMI, WC, and WHtR were measured during donor screening. The outcome postdonation kidney function was assessed using measured GFR (mGFR) (mGFR, 125 I-iothalamate infusion) at 3 months ( n =1042), 5 years ( n =556), and 10 years ( n =210) of follow-up. Primary multivariable linear regression analyses were performed with BMI and WC and secondary analyses with WHtR. Linear mixed models were performed to investigate change in postdonation eGFR | ||
| 520 | |a RESULTS: The donor age was 52±11 years, and 48% were male. The mean BMI was 26.1±3.6 kg/m 2 , and WC was 91±11 cm. Higher predonation BMI was associated with lower mGFR throughout follow-up: -1.35 (95% confidence interval [CI], -1.95 to -0.80), -1.55 (95% CI, -2.50 to -0.65), and -2.35 (95% CI, -4.10 to -0.60) ml/min per m 2 per 5 kg/m 2 higher BMI at 3 months, 5, and 10 years after donation, respectively, adjusted for sex, age, and predonation GFR. For WC, differences in mGFR were -1.30 (95% CI, -1.70 to -0.90), -1.50 (95% CI, -2.20 to -0.80), and -1.70 (95% CI, -3.00 to -0.50) ml/min per m 2 per 10 cm higher WC at 3 months, 5, and 10 years after donation, respectively. In male donors, BMI and WC were significantly associated with a negative postdonation change in eGFR | ||
| 520 | |a CONCLUSIONS: Higher BMI and WC were independently associated with lower GFR (long term) after living kidney donation | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Pol, Robert A |e verfasserin |4 aut | |
| 700 | 1 | |a van der Weijden, Jessica |e verfasserin |4 aut | |
| 700 | 1 | |a de Borst, Martin H |e verfasserin |4 aut | |
| 700 | 1 | |a Bakker, Stephan J L |e verfasserin |4 aut | |
| 700 | 1 | |a van Londen, Marco |e verfasserin |4 aut | |
| 700 | 0 | |a on behalf of the Transplant Lines Investigators |e verfasserin |4 aut | |
| 700 | 1 | |a Annema, Coby |e investigator |4 oth | |
| 700 | 1 | |a Berger, Stefan P |e investigator |4 oth | |
| 700 | 1 | |a Blokzijl, Hans |e investigator |4 oth | |
| 700 | 1 | |a Bodewes, Frank A J A |e investigator |4 oth | |
| 700 | 1 | |a de Boer, Marieke T |e investigator |4 oth | |
| 700 | 1 | |a Damman, Kevin |e investigator |4 oth | |
| 700 | 1 | |a de Borst, Martin H |e investigator |4 oth | |
| 700 | 1 | |a Diepstra, Arjan |e investigator |4 oth | |
| 700 | 1 | |a Dijkstra, Gerard |e investigator |4 oth | |
| 700 | 1 | |a Douwes, Rianne M |e investigator |4 oth | |
| 700 | 1 | |a Doorenbos, Caecilia S E |e investigator |4 oth | |
| 700 | 1 | |a Eisenga, Michele F |e investigator |4 oth | |
| 700 | 1 | |a Erasmus, Michiel E |e investigator |4 oth | |
| 700 | 1 | |a Gan, C Tji |e investigator |4 oth | |
| 700 | 1 | |a Gomes Neto, Antonio W |e investigator |4 oth | |
| 700 | 1 | |a Hak, Eelko |e investigator |4 oth | |
| 700 | 1 | |a Hepkema, Bouke G |e investigator |4 oth | |
| 700 | 1 | |a van den Heuvel, Marius C |e investigator |4 oth | |
| 700 | 1 | |a Klont, Frank |e investigator |4 oth | |
| 700 | 1 | |a Knobbe, Tim J |e investigator |4 oth | |
| 700 | 1 | |a Kremer, Daan |e investigator |4 oth | |
| 700 | 1 | |a van Leer-Buter, Coretta |e investigator |4 oth | |
| 700 | 1 | |a Leuvenink, Henri G D |e investigator |4 oth | |
| 700 | 1 | |a van Londen, Marco |e investigator |4 oth | |
| 700 | 1 | |a Lexmond, Willem S |e investigator |4 oth | |
| 700 | 1 | |a de Meijer, Vincent E |e investigator |4 oth | |
| 700 | 1 | |a Niesters, Hubert G M |e investigator |4 oth | |
| 700 | 1 | |a Nieuwenhuis-Moeke, Gertrude J |e investigator |4 oth | |
| 700 | 1 | |a Joost van Pelt, L |e investigator |4 oth | |
| 700 | 1 | |a Pol, Robert A |e investigator |4 oth | |
| 700 | 1 | |a Porte, Robert J |e investigator |4 oth | |
| 700 | 1 | |a Ranchor, Adelta V |e investigator |4 oth | |
| 700 | 1 | |a Sanders, Jan Stephan F |e investigator |4 oth | |
| 700 | 1 | |a Siebelink, Marion J |e investigator |4 oth | |
| 700 | 1 | |a Slart, Riemer J H J A |e investigator |4 oth | |
| 700 | 1 | |a Swarte, J Cas |e investigator |4 oth | |
| 700 | 1 | |a Touw, Daan J |e investigator |4 oth | |
| 700 | 1 | |a Te Velde-Keyzer, Charlotte A |e investigator |4 oth | |
| 700 | 1 | |a Verschuuren, Erik A M |e investigator |4 oth | |
| 700 | 1 | |a Vos, Michel J |e investigator |4 oth | |
| 700 | 1 | |a Weersma, Rinse K |e investigator |4 oth | |
| 700 | 1 | |a Bakker, Stephan J L |e investigator |4 oth | |
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