Metabolic Syndrome Predicts Worse Long-Term Renal Outcomes in Living Kidney Donors (LKDs)

M. Merzkani¹, A. Denic¹, M. D'Costa¹, L. Ricaurte¹, R. Narasimhan¹, X. Benavides¹, A. Mullan¹, J. Larson¹, W. Kremers¹, W. Park¹, M. P. Alexander¹, S. Textor¹, S. Taler¹, H. Chakkera², M. Stegall¹, N. Issa¹, A. Rule¹

¹Mayo Clinic, Rochester, MN, ²Mayo Clinic, Scottsdale, AZ

Meeting: 2020 American Transplant Congress

Abstract number: C-082

Keywords: Obesity, Renal function

Session Information

Session Name: Poster Session C: Kidney Living Donor: Long Term Outcomes

Session Type: Poster Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:00pm

Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose: Prior studies linked metabolic syndrome with worse kidney outcomes in a variety of populations. In this study, we assessed the long-term risk of reduced kidney function in the presence of metabolic syndrome in LKDs.

*Methods: We performed a multicenter prospective study of LKDs between 1999 and 2012. We studied 1025 LKDs who were at least 5 years post-donation and completed a survey from 2017 to 2019 and an additional 201 kidney donors who received medical care at the transplant center during the same time frame. Metabolic syndrome was defined as having ≥3 criteria: 1) BMI ≥30 kg/m²; 2) fasting glucose ≥100 mg/dl, 3) triglycerides ≥150 mg/dl, HDL ≤ 50mg/dl (female) or ≤40mg/dl (male), or 4) office blood pressure ≥130/85 mmHg. Impaired fasting glucose (IFG) was defined as a fasting glucose 100-125mg/dl. The outcomes studied were a follow-up eGFI<45ml/min, proteinuria, or a composite endpoint of either eGFR<45 ml/min or proteinuria (reported as abnormal however measured). Analyses were adjusted for age, sex, and time since donation.

*Results: The mean follow up was 10.6 years. Prevalence of predonation metabolic syndrome was 16.7%, predonation obesity 28.5%, IFG 22.5%, eGFR<45 7.0%, proteinuria 5.1% (41/809), and composite adverse renal outcome 9.8% (100/1019). After adjustment, obesity and IFG did not associate with the composite endpoint (OR=0.81, p=0.21; OR=1.4, p=0.70 respectively), whereas metabolic syndrome associated with composite end point in unadjusted and adjusted model (OR=2.0, p=0.008). Metabolic syndrome predicted self-reported proteinuria (OR=2.8, p=0.006) but not eGFR <45 ml/min (OR=1.77, p=0.08). Serum uric acid, often viewed as a biomarker of metabolic syndrome, predicted an eGFR<45ml/min (OR=1.3, p=0.006) and proteinuria (OR=1.43, p<0.0001).

*Conclusions: As in other populations, metabolic syndrome and elevated serum uric acid predict worse long-term renal outcomes in LKD’s. Individual components of metabolic syndrome such as obesity or IFG were not as predictive.

To cite this abstract in AMA style:

Merzkani M, Denic A, D'Costa M, Ricaurte L, Narasimhan R, Benavides X, Mullan A, Larson J, Kremers W, Park W, Alexander MP, Textor S, Taler S, Chakkera H, Stegall M, Issa N, Rule A. Metabolic Syndrome Predicts Worse Long-Term Renal Outcomes in Living Kidney Donors (LKDs) [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/metabolic-syndrome-predicts-worse-long-term-renal-outcomes-in-living-kidney-donors-lkds/. Accessed May 16, 2025.

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