Kidney Week

Abstract: TH-PO143

Obesity Is a Risk Factor for ESRD in Prior Living Kidney Donors

Session Information

• Transplantation: Cardiovascular and Metabolic Diseases
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 1802 Transplantation: Clinical

Authors

• Brar, Amarpali, SUNY Downstate Medical Center, Brooklyn, New York, United States

Amarpali Brar,

• Gruessner, Angelika C., SUNY Downstate Medical Center, Brooklyn, New York, United States

Angelika C. Gruessner,

• Jindal, Rahul M., Uniformed Services University of Health Sciences, Silver Spring, Maryland, United States

Rahul M. Jindal,

• Nee, Robert, Walter Reed National Military Medical Center, Vienna, Virginia, United States

Robert Nee,

• Stefanov, Dimitre, SUNY Downstate Medical Center, Brooklyn, New York, United States

Dimitre Stefanov,

• Salifu, Moro O., SUNY Downstate Medical Center, Brooklyn, New York, United States

Moro O. Salifu,

Background

Living donors undergo extensive evaluation prior to donation. Despite that some living kidney donors (LKDs) progress to end stage renal disease (ESRD). We evaluated the trends and characteristics of LKDs who were waitlisted for kidney transplantation.

Methods

We used the United Network for Organ Sharing data to identify 524 LKDs who were listed for kidney transplantation from 1993-2017. For qualitative variables, frequencies were computed and the tests of association were performed using the chi-square test.

Results

In this cohort, 59.8% (n=313) were men and 40.2% (n= 211) women. Cause of ESRD was diabetes in 17.5%, hypertension in 32% and other in 44%. Forty six % were White, 38.5% Black, 10% Hispanic, 2.2% Asian, 1.9 % Native -American and 1.1% were multiracial. Mean age at listing was 55 yrs ±11.4. Figure 1 shows the increasing number of prior LKDs who waitlisted from 1993- 2017. The number of Black LKDs who waitlisted were disproportionately higher (38.5%) as compared to the proportion of Black LKDs in this time period varying from 8% to 12%. Hypertension as a cause of ESRD was observed to be much higher in Blacks (41.1%) and Hispanics (32%) as compared to Whites (26%), p= 0.02. Mean BMI at time of waitlisting was 29.5 ± 5.2 kg/m². Among LKDs who were listed for transplantation, majority were overweight (36%) or obese (43.%). Forty-one percent of (n=100) white, 46% (n=93) black, 46 % Hispanic (n=24) and 25.3 %( n=7) multiracial prior LKDs were obese (>30kg/m²) at time of wait listing, p=0.18.

Conclusion

Transplantation centers now approve more medically complex obese LKDs without supporting data. Informed consent with obese individuals are critical in those considering LKD. Life style changes and modifications should be addressed in those with normal BMI at time of donation to avoid future obesity. Long-term studies are needed to understand risks associated with hypertension and obesity focused on minority LKDs