Impact of Post-Donation Body Weight Changes on Kidney Donor Blood Pressure, Kidney Function and Metabolic Parameters
Nephrology and HTN, Cleveland Clinic, Cleveland, OH
Quatitative Health Sciences, Cleveland Clinic, Cleveland, OH
Nephrology and HTN, Mayo Clinic, Rochester, MN
Meeting: 2013 American Transplant Congress
Abstract number: B920
Obesity has been associated with chronic kidney disease and its risk factors. Therefore, we hypothesized that weight increase post-donation would adversely affect kidney function, blood pressure, and metabolic risk factors in living kidney donors (LKD).
Methods: We studied 227 LKD and assessed BP changes and risk factors that are used to define metabolic syndrome in relation to change in weight (kg) and BMI from pre- to post-donation. Median time of follow up was 439 days (194860 days).
Results: Increased body weight after donation was present in 112 (49.3%) donors. When compared to those who lost or maintained weight, donors with weight gain were more likely to have an increase in systolic blood pressure and triglycerides and a decrease in HDL-cholesterol levels (see Table). These changes were independent statistically in a multivariable model (p<.05 for all). Importantly, change in GFR and fasting glucose were not different between groups (-32.8±9.4 vs -31.8±9.6, p=0.441). These changes led to the new diagnosis of metabolic syndrome in 15.5% of the donors and reversal of metabolic syndrome in 9.1% (p=0.009).
Weight Loss | Weight Gain | p value | |
% change in BMI | -4.3±3.8 | +6.6±5.8 | <0.001 |
% change in SBP | -1.4±11.4 | +3.0±11.7 | 0.005 |
% change in triglycerides | +6.1±44.8 | +38.3±69.2 | <0.001 |
% change in HDL-chol | +4.6±16.4 | -3.8±18.2 | 0.001 |
% change in fasting glucose | -1.4±18.8 | +0.5±12.3 | 0.383 |
% change in GFR | -32.8 | -31.8 | 0.441 |
To validate these results, we queried the SRTR database. Among 13,451 donors in the US (2004-2011), a weight gain of at least 5 kg by one year of follow up had a statistically significant positive association with an increased systolic (+2.6 mmHg, p<0.001) and diastolic blood pressures (+1.5 mmHg, p<0.001) in multivariable models adjusted for age, gender and race when compared to other donors.
Conclusions: Post-donation body weight changes are prevalent and associate with adverse changes in BP and lipids. Weight control is a modifiable risk factor which drives other metabolic abnormalities, hence the importance of emphasizing lifestyle modification behaviors in LKDs.
To cite this abstract in AMA style:
Heaphy E, Ohashi Y, Stephany B, Nurko S, Fatica R, Amer H, Rule A, Schold J, Poggio E. Impact of Post-Donation Body Weight Changes on Kidney Donor Blood Pressure, Kidney Function and Metabolic Parameters [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/impact-of-post-donation-body-weight-changes-on-kidney-donor-blood-pressure-kidney-function-and-metabolic-parameters/. Accessed October 3, 2024.« Back to 2013 American Transplant Congress