Kidney Week

Abstract: PUB331

In-Depth Analysis of the Molecular Changes Induced by Short-Term Calorie Restriction Before Living Kidney Donation

Session Information

• Publication Only

Category: Transplantation

• 2101 Transplantation: Basic

Authors

• Späth, Martin R., Department II of Internal Medicine and Center for Molecular Medicine Cologne, University Hospital of Cologne, Cologne, Germany

Martin R. Späth, MD

• Arjune, Sita, Policlinic for Endocrinology, Diabetes and Preventive Medicine (PEPD), University Hospital of Cologne, Cologne, Germany

Sita Arjune, PhD

• Bohl, Katrin, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University Hospital of Cologne, Cologne, Germany

Katrin Bohl, PhD

• Rinschen, Markus M., III. Department of Medicine, Hamburg Center for Kidney Health, University Hospital of Hamburg, Hamburg, Germany

Markus M. Rinschen, MD

• Antczak, Philipp, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University Hospital of Cologne, Cologne, Germany

Philipp Antczak, PhD

• Grundmann, Franziska, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University Hospital of Cologne, Cologne, Germany

Franziska Grundmann, MD, DrMed

• Kubacki, Torsten, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University Hospital of Cologne, Cologne, Germany

Torsten Kubacki, MD

• Hoyer-Allo, Karla Johanna Ruth, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University Hospital of Cologne, Cologne, Germany

Karla Johanna Ruth Hoyer-Allo, MD

• Ignarski, Michael, Cologne Excellence Cluster for Aging and Aging-Associated Diseases, University Hospital of Cologne, Cologne, Germany

Michael Ignarski, PhD

• Koehler, Felix C., Department II of Internal Medicine and Center for Molecular Medicine Cologne, University Hospital of Cologne, Cologne, Germany

Felix C. Koehler, MD

• Lackmann, Jan-Wilm, Cologne Excellence Cluster for Aging and Aging-Associated Diseases, University Hospital of Cologne, Cologne, Germany

Jan-Wilm Lackmann, PhD

• Wahida, Adam, Medical Department III of Hematology and Oncology, University Hospital of Ludwig Maximilian University of Munich, Munich, Germany

Adam Wahida, MD, PhD

• Kemmner, Stephan, Transplant Center, University Hospital Munich, Ludwig-Maximilians-University (LMU), Munich, Germany

Stephan Kemmner, MD, DrMed

• Wagner, Tristan, Department of General, Visceral, Thoracic and Transplantation Surgery, University Hospital of Cologne, Cologne, Germany

Tristan Wagner

• Thomas, Michael Nikolaus, Department of General, Visceral, Thoracic and Transplantation Surgery, University Hospital of Cologne, Cologne, Germany

Michael Nikolaus Thomas

• Kurschat, Christine E., Department II of Internal Medicine and Center for Molecular Medicine Cologne, University Hospital of Cologne, Cologne, Germany

Christine E. Kurschat, MD

• Benzing, Thomas, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University Hospital of Cologne, Cologne, Germany

Thomas Benzing, MD, PhD, FASN

• Stippel, Dirk L., Department of General, Visceral, Thoracic and Transplantation Surgery, University Hospital of Cologne, Cologne, Germany

Dirk L. Stippel, DrMed, MBA

• Burst, Volker Rolf, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University Hospital of Cologne, Cologne, Germany

Volker Rolf Burst, MD

• Mueller, Roman-Ulrich, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University Hospital of Cologne, Cologne, Germany

Roman-Ulrich Mueller, MD

Group or Team Name

• Translational Nephrology Cologne.

Background

Ischemia-reperfusion injury (IRI) is a central cause of acute kidney injury (AKI) and one of the key factors influencing future outcome after kidney transplantation. In rodent models, short-term calorie restriction (CR) before IRI has proven to be very effective in preventing acute kidney injury (AKI). However, translation to the patient setting is lagging behind, partly due to the fact that knowledge on the molecular mechanisms underlying this protection is limited in rodents and lacking in humans. The aim of this study was to characterize clinical and molecular effects of short-term CR in kidney donors.

Methods

12 living kidney donors were alternately assigned to a CR or stayed on ad libitum diet. The CR-donors received a formula diet, 50% of individual calorie requirements, for the last 7 days before kidney donation. In addition to clinical parameters (e. g. bodyweight or creatinine), biosamples of perirenal fat, kidney biopsy specimens and blood were collected. The primary outcome measures were the CR-mediated molecular effects in the donor biosamples. The clinical impact was examined as a secondary outcome.

Results

The diet was well tolerated and led to significant weight loss in the CR group. There was no influence on the occurrence of AKI and or diet-associated adverse events. Lipidomic and proteomic analyses revealed an activation of lipolysis, an influence of sex and a downregulation of insulin-signaling.

Conclusion

This pilot study confirms that a short-term CR before living kidney donation can be safely implemented and that known CR-mediated mechanisms, e. g. reduction of insulin signaling, are conserved in humans. This provides a good starting point for future studies targeting these pathways in larger interventional studies.

Funding

• Commercial Support – Fresenius Kabi

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025z9q8qeyb