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Weight gain after kidney donation: Association with increased risks of type 2 diabetes and hypertension
Author(s) -
Issa Naim,
Sánchez Otto A.,
Kukla Aleksandra,
Riad Samy M.,
Berglund Danielle M.,
Ibrahim Hassan N.,
Matas Arthur J.
Publication year - 2018
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13360
Subject(s) - medicine , body mass index , diabetes mellitus , weight gain , population , obesity , relative risk , incidence (geometry) , kidney disease , surgery , endocrinology , confidence interval , body weight , physics , environmental health , optics
In the general population, obesity is associated with an increased risk of developing hypertension ( HTN ), type 2 diabetes mellitus ( DM ), and end‐stage renal disease ( ESRD ). Therefore, most transplant centers have a body mass index ( BMI ) threshold for accepting living kidney donors. But there have been no studies of postdonation weight gain trends and any associated risks. We tracked serial BMI s in 940 donors for a median ( IQ range) follow‐up of 22.3 (15.4‐35.8) years. We studied the impact of postdonation weight gain in a model adjusted for family history of HTN or DM . Donor characteristics included age, sex, smoking, fasting blood glucose, eGFR , systolic and diastolic BP , and BMI at time of donation and time postdonation. Postdonation weight gain was associated with a significant increase in the relative risk of developing HTN RR 1.93 (95% CI 1.51‐2.46) ( P < 0.001) and/or DM RR 4.18 (95% CI 2.05‐8.5) ( P < 0.0001), but not (to date) cardiovascular disease ( CVD ), reduced eGFR or death. Like the general population, donors gained weight as they aged; a higher BMI was associated with higher incidence of DM and HTN . Postdonation care should include ongoing counseling on the risks of substantial weight gain.