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Copyright ©The Author(s) 2021.
World J Transplant. Jun 18, 2021; 11(6): 180-186
Published online Jun 18, 2021. doi: 10.5500/wjt.v11.i6.180
Table 1 Summary of studies addressing outcome of hypertensive and obese living kidney donors post-donation
Ref.
Donors (n)
Follow up period
Obesity pre-donation
Hypertension pre-donation
Thukral et al[7]655 yr26% had BMI > 25 at the time of donation. Significant increase in BMI and drop in eGFR at 5-year follow up. 22.3% later developed DM as well49.3% with no h/o prior HTN. Significant increase in mean SBP, DBP and number of HTN medications in patients with prior HTN at 5-yr follow-up
Tavakol et al[15]98Donors from 1967-2003 compared to two-kidney controls 2005-200616 obese donors (BMI > 30) with none having DM at the time of donation. No significant difference in decrease in GFR in obese vs non-obese groups. Obese patients had more proteinuria and albuminuria on multivariate analysisNo patient had HTN at donation. Significantly, more obese patients developed HTN
Serrano et al[17]375210-40 yr652 obese donors (17%, BMI > 30). Intra operative time longer in obese. No significant difference in short- (< 30 d) and long- (> 30 d) term readmission. No difference in GFR and ESRD development in obese patientsSignificant difference in long term development of DM and HTN in obese patients
Rea et al[14]49340 d49 obese donors (mean BMI 37.6 ± 5.0) vs 41 non-obese donors (mean BMI 24.8 ± 2.2). No significant difference in pre-and post-donation serum creatinine and micro-albuminuria
Kerkeni et al[16]1899.28 yrNo significant increase in post-operative complications. High BMI patients (mean BMI 26.8) maintained normal renal functions and didn’t developed proteinuria as compared to lower BMI patient (mean BMI 25.2 kg/m2) and this difference was not significant
Lafranca et al[18]14 studies, 1192 donorsSystematic reviewOperation duration and conversion rate from Laproscopic to open procedure was significantly higher in high BMI group (BMI > 30). No significant difference in decrease in eGFR, peri-operative complication rates
Praga et al[27]73> 12 mo (13.6 ± 8.6 yr)Significant difference in development of renal insufficiency and proteinuria in obese patients (BMI > 30) as compared to non-obese patient even after multiple regression analysis
Nogueira et al[28]397.1 ± 1.6 yrSignificant difference in decrease in eGFR from baseline in obese patients (BMI > 35 kg/m2)
Ozdemir et al[37]226515 yr6.21-fold high risk of ESRD in 15 yr in patients with pre-donation HTN controlled on medications
Quadri et al[44]1296895 yrAmong those with age < 50 yr, pre-existing HTN + obesity (BMI > 30 kg/m2) were associated with a 24-fold increased risk of no eGFR compensation of the remaining kidney over 5 yr post-donation