Prehypertension and Abnormal Fasting Glucose Are the Main Factors Associated With Progressive Deterioration of Renal Function in Kidney Donors

J. Arreola-Guerra,¹ M. Arvizu-Hernandez,² R. Correa-Rotter,² L. Morales-Buenrostro,² J. Alberu.¹

¹Transplantation, National Institute of Nutrition and Medical Sciences Salvador Zubirán, Mexico City, Mexico
²Nephrology and Mineral Metabolism, National Institute of Nutrition and Medical Sciences Salvador Zubirán, Mexico City, Mexico.

Meeting: 2015 American Transplant Congress

Abstract number: B164

Keywords: Donation, Risk factors

Session Information

Session Name: Poster Session B: Living Donor Issues 1

Session Type: Poster Session

Date: Sunday, May 3, 2015

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

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

Location: Exhibit Hall E

Background: For reasons unclarified, some kidney donors (KD) are patients (pts) that throughout its evolution remain with the same renal function (RF) or even continue to rise, while another group of pts has annual impairment. This study will look for factors associated with progressive deterioration of RF in donors. Methods: This is a cohort study of KD. RF was assessed by the estimation formula CKD-EPI (eGFR) at 3 to 6 months postnephrectomy and at the end of follow-up. They classified pts as positive or negative slope according to the trend of eGFR over time of evolution (eGFR 3 to 6 mo postnephrectomy – eGFR last follow-up) ÷ (years of follow-up). Results: We included 162 pts with mean age to donation of 36.5y (± 11.9), slight predominance of females (56.1%). The average follow-up time was 12.5y (± 6.7). Pts classified as negative slope had an average annual loss of: -1.7 ml/min (min-max -0.5 to -7.0), while positive slope group had +0.83 ml/min (min-max -0.47 to +10.04). Upon completion of the follow-up, 13 of the 41 pts classified as negative slope group, had a eGFR below 60 ml/min, (31.7% vs 19.1%, p= 0.09) and 5 of them below 45 ml/min (12.2% vs 25.1% p= 0.012). Factors associated with negative slope are presented in Table 1.

Risk factors for negative slope of renal function. Logistic regression model
Variables	Univariate OR(CI95%)	p value	Multivariate 1 OR(CI95%)	p value	Multivariate 2 OR (CI95%)	p value
Age	1.05(0.9 – 1.03)	0.74	1.04 (1.008 – 1.08)	0.017	1.001 (0.9 – 1.03)	0.92
Male	2.2 (1.1 – 4.6)	0.02	2.5 (1.1 – 5.9)	0.024	2.2 (1.04 – 4.6)	0.038
Pre-HAS	3.1 (1.3 – 7.5)	0.01	2.8 (1.04 – 7.6)	0.04	2.5 (1.02 – 6.5)	0.04
AFG	2.03 (1.1 – 6.3)	0.02			2.4 (1.001 – 6.1)	0.05
Obesity	2.7 (0.8 – 8.7)	0.08
eGFR 3Mo	1.05 (1.02 – 1.07)	<0.01	1.07 (1.03 – 1.1)	<0.01

Male = Male sex. Pre-HAS = Prehypertension: BP >130/85 mmHg and <140/90 mmHg. AFG = Abnormal Fasting Glucose: glucose >100 mg/dL and <126 mg/dL. Obesity: Body Mass Index >27.5Kg/m2, eGFR 3Mo= estimated Glomerular Filtration Rate month 3 to 6 postnephrectomy.Conclusions: Negative slope of renal function after nephrectomy is a risk factor for developing CKD. Prehypertension and abnormal fasting glucose were the most important modifiable factors in predicting the deterioration of RF postnephrectomy.

To cite this abstract in AMA style:

Arreola-Guerra J, Arvizu-Hernandez M, Correa-Rotter R, Morales-Buenrostro L, Alberu J. Prehypertension and Abnormal Fasting Glucose Are the Main Factors Associated With Progressive Deterioration of Renal Function in Kidney Donors [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/prehypertension-and-abnormal-fasting-glucose-are-the-main-factors-associated-with-progressive-deterioration-of-renal-function-in-kidney-donors/. Accessed November 21, 2024.

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