Overweight Kidney Donors Gain Weight after Donation

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Abstract

Introduction

Living kidney donors remain at low risk of end stage kidney disease but obese and overweight donors' risk is increased. We aimed to describe the trajectory of weight changes pre/post donation to aid in donor risk assessment.

Methods

A single center retrospective chart review from 1/2009-12/2017 was performed. Demographics, height and weight measures from hospital and clinic visits were collected. Patients were categorized by BMI (kg/m2) at time of donation. Mean weight at time of initial assessment, kidney donation, 12 mos follow-up and last follow-up were calculated. Paired t-tests compared mean differences in weight at kidney donation relative to other time points.

Results

195 donors were included for analysis. Mean (SD) age was 47±13 years and 73% were female. At donation, 2 patients (1.0%) had BMI <18.5 kg/m2 (underweight); 49 (25.1%) BMI 18.5-24.9 (healthy weight); 85 (43.6%) BMI 25-29.9 (overweight); 46 (23.6%) BMI 30-34.9 (Class 1 Obesity); 13 (6.7%) BMI 35-39.9 (Class 2 Obesity). Weight loss occurred prior to donation in the BMI 18.5-24.9 group and did not change post-donation. Significant weight gain occurred following donation in patients with BMI ≥ 25 (P<0.0001).

Conclusions

Despite KDIGO recommendations that obese and overweight patients pursue weight loss before donation and donors maintain a healthy weight after donation, this is not what occurred. Significant weight gain occurred in patients with BMI ≥ 25 at donation. This finding may influence donor risk assessment. Our results highlight the need for effective weight loss interventions both pre- and post-donation.

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