Effect of Living Kidney Donation on Glucose Metabolism and Insulin Resistance

B. Tanriover,¹ P. Mohan,² S. Cremers,³ I. Lingvay.⁴

¹Medicine/Nephrology, UT Southwestern, Dallas, TX
²Medicine/Nephrology, Medical University of South Carolina, Charleston, SC
³Biomarkers Core Laboratory, Columbia University, New York, NY
⁴Medicine/Endocrinology, UT Southwestern, Dallas, TX.

Meeting: 2015 American Transplant Congress

Abstract number: C281

Keywords: Donation, Insulin, Kidney, Metabolic complications

Session Information

Session Name: Poster Session C: Translational Biomarkers and Immune Monitoring

Session Type: Poster Session

Date: Monday, May 4, 2015

Session Time: 5:30pm-6:30pm

Presentation Time: 5:30pm-6:30pm

Location: Exhibit Hall E

The kidney contributes to glucose hemostasis through processes of insulin metabolism, gluconeogenesis, and glucose filtration. Little is known on insulin sensitivity in living kidney donors following nephrectomy. Reduction in total GFR 25-30 ml/min after nephrectomy and remaining kidney hyper-filtration in living donors may lead to insulin resistance.

We conducted a pilot study and enrolled 9 living kidney donors. We assessed insulin sensitivity by static measurements (fasting glucose, insulin), dynamic testing (mixed meal tolerance test – MMTT for glucose and insulin AUC calculation) and metabolic phenotyping (metabolic syndrome criteria and family history of diabetes) before and 3-months after nephrectomy.

Results are shown in the table.

Baseline and post-nephrectomy changes in glucose metabolism and insulin sensitivity.
	Pre-nephrectomy, Median (Min, Max)	Post-nephrectomy Median (Min, Max)	Delta (Post-Pre), Median (Min, Max)	P value *
Weight (kg)	85.8 (53.9, 110.5)	87 (53.2, 116.8)	0 (-2.3, 6.35)	0.476
BMI (kg/m2)	29 (21.5, 36.7)	30.5 (21.2, 38.1)	0.04 (-2.70, 2.08)	0.476
SBP (mmHg)	112 (100, 128)	115 (109, 120)	3 (-8, 8)	0.588
DBP (mmHg)	62 (60, 80)	72 (66, 81)	6 (2, 12)	0.042
HbA1C (%)	5.4 (4.7, 6)	5.4 (4.6, 5.9)	0 (-0.2, 0.3)	0.715
Fasting glucose (mg/dL)	95 (75, 105)	93 (74, 105)	-3 (-6, 130)	0.514
Fasting insulin (mU/mL)	8.4 (5, 19.7)	11.4 (6.4, 25)	3.4 (-1.4, 15.3)	0.018
Glucose 2hr (mg/dL)	119 (72, 135)	92 (82, 117)	-21 (-43, 19)	0.050
TG/HDL-C	1.73 (0.50, 3.57)	2.55 (0.51, 5.37)	0.65 (-1.0, 1.8)	0.214
eGFR (mL/min/1.73 m2)	108 (77.6, 120)	76.5 (58, 94)	-38.5 (-47.9, -28)	0.012
MMTT
Glucose AUC (h*mg/dL)	228.9 (48.9, 247.5)	209.3 (178.8, 262.8)	3.2 (-49.1, 139)	0.767
Insulin AUC (h*mU/mL)	60.7 (34.8, 134.8)	101.7 (23.8, 189)	33.3 (-16, 107.7)	0.036
AUCins/glu(mU/mg)	24.7 (16.4, 60.5)	49.6 (12.3, 95.3)	14 (-4.1, 49.1)	0.011
Insulin resistance surrogate indices
HOMA-IR**	2.0 (0.96, 4.9)	2.87 (1.2, 5.9)	0.8 (-0.3, 3.9)	0.028
Matsuda index***	5.9 (2.5, 13.6)	3.87 (2.0, 11)	-2 (-4, 2.9)	0.051

*Wilcoxon signed-rank test. **HOMA-IR >2.5 shows liver insulin resistance.*** Matsuda index <2.5 shows whole body insulin resistance.After nephrectomy, there is a significant increase in serum insulin secretion and HOMA-IR, and a decrease in Matsuda index. Further studies are need to explore renal glucose handling in living donors.

To cite this abstract in AMA style:

Tanriover B, Mohan P, Cremers S, Lingvay I. Effect of Living Kidney Donation on Glucose Metabolism and Insulin Resistance [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/effect-of-living-kidney-donation-on-glucose-metabolism-and-insulin-resistance/. Accessed November 21, 2024.

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