Association of metabolic syndrome with kidney function and histology in living kidney donors

Y. Ohashi, G. Thomas, S. Nurko, B. Stephany, R. Fatica, A. Chiesa, A. D. Rule, T. Srinivas, J. D. Schold, S. D. Navaneethan, E. D. Poggio

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26 Scopus citations

Abstract

The selection of living kidney donors is based on a formal evaluation of the state of health. However, this spectrum of health includes subtle metabolic derangements that can cluster as metabolic syndrome. We studied the association of metabolic syndrome with kidney function and histology in 410 donors from 2005 to 2012, of whom 178 donors were systematically followed after donation since 2009. Metabolic syndrome was defined as per the NCEP ATPIII criteria, but using a BMI > 25 kg/m2 instead of waist circumference. Following donation, donors received counseling on lifestyle modification. Metabolic syndrome was present in 50 (12.2%) donors. Donors with metabolic syndrome were more likely to have chronic histological changes on implant biopsies than donors with no metabolic syndrome (29.0% vs. 9.3%, p < 0.001). This finding was associated with impaired kidney function recovery following donation. At last follow-up, reversal of metabolic syndrome was observed in 57.1% of donors with predonation metabolic syndrome, while only 10.8% of donors developed de novo metabolic syndrome (p < 0.001). In conclusion, metabolic syndrome in donors is associated with chronic histological changes, and nephrectomy in these donors was associated with subsequent protracted recovery of kidney function. Importantly, weight loss led to improvement of most abnormalities that define metabolic syndrome. Nephrosclerosis in living kidney donors with metabolic syndrome associates with postdonation protracted recovery of kidney function; however, weight loss can lead to improvement of relevant metabolic factors and achieve reversal of the metabolic syndrome. See editorial by Doshi on page 2241.

Original languageEnglish (US)
Pages (from-to)2342-2351
Number of pages10
JournalAmerican Journal of Transplantation
Volume13
Issue number9
DOIs
StatePublished - Sep 1 2013

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Keywords

  • Body mass index
  • kidney transplant
  • living donor
  • metabolic syndrome
  • nephrosclerosis
  • outcomes

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

Cite this

Ohashi, Y., Thomas, G., Nurko, S., Stephany, B., Fatica, R., Chiesa, A., Rule, A. D., Srinivas, T., Schold, J. D., Navaneethan, S. D., & Poggio, E. D. (2013). Association of metabolic syndrome with kidney function and histology in living kidney donors. American Journal of Transplantation, 13(9), 2342-2351. https://doi.org/10.1111/ajt.12369