Metabolic risks in living kidney donors in South Korea

Kang, Eunjeong; Park, Jina; Kim, Hyo Jeong; Park, Sehoon; Park, Minsu; Kim, Yaerim; Kim, Kwangsoo; Park, Sang Min; Chae, Dong‐Wan; Chin, Ho Jun; Lee, Jung Pyo; Lee, Sik; Kim, Soo Wan; Cho, Jang‐Hee; Kim, Yong Chul; Kim, Yon Su; Choi, In–Hwan; Lee, Hajeong

doi:10.23876/j.krcp.20.271

Cited by 6 publications

(5 citation statements)

References 33 publications

(41 reference statements)

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“…The development of metabolic syndrome has been studied in kidney donors. An analysis of 2018 Living kidney donors, when matched with control non-donors, found that the living kidney donors showed a lower absolute prevalence for all metabolic risk factors, except for those who were either overweight or obese[ 176 ]. However, in another study, more donors developed new onset metabolic syndrome compared to the control group[ 177 ].…”

Section: What Risk Factors Make Pd Riskier?mentioning

confidence: 99%

Pros and cons of live kidney donation in prediabetics: A critical review and way forward

Khalil,

Sadagah,

Tan

et al. 2024

World J Transplant

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There is shortage of organs, including kidneys, worldwide. Along with deceased kidney transplantation, there is a significant rise in live kidney donation. The prevalence of prediabetes (PD), including impaired fasting glucose and impaired glucose tolerance, is on the rise across the globe. Transplant teams frequently come across prediabetic kidney donors for evaluation. Prediabetics are at risk of diabetes, chronic kidney disease, cardiovascular events, stroke, neuropathy, retinopathy, dementia, depression and nonalcoholic liver disease along with increased risk of all-cause mortality. Unfortunately, most of the studies done in prediabetic kidney donors are retrospective in nature and have a short follow up period. There is lack of prospective long-term studies to know about the real risk of complications after donation. Furthermore, there are variations in recommendations from various guidelines across the globe for donations in prediabetics, leading to more confusion among clinicians. This increases the responsibility of transplant teams to take appropriate decisions in the best interest of both donors and recipients. This review focuses on pathophysiological changes of PD in kidneys, potential complications of PD, other risk factors for development of type 2 diabetes, a review of guidelines for kidney donation, the potential role of diabetes risk score and calculator in kidney donors and the way forward for the evaluation and selection of prediabetic kidney donors.

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Section: What Risk Factors Make Pd Riskier?mentioning

confidence: 99%

Pros and cons of live kidney donation in prediabetics: A critical review and way forward

Khalil,

Sadagah,

Tan

et al. 2024

World J Transplant

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“…The primary and independent risk factors for hypertension and atherosclerotic CVD in donors were older age, obesity, smoking, and hyperlipidemia [22]. Kang et al studied the postoperative prevalence of metabolic risk factors, including hypertension, hyperuricemia, hypercholesterolemia, and obesity, in 2,018 LKT donors and matched non-donors [25]. The LKT donors showed a lower prevalence of metabolic risk factors except for obesity.…”

Section: Pre- and Post-kt Comorbidities Of Lkt Donorsmentioning

confidence: 99%

Donor Evaluation of Living Kidney Transplantation in the Aging Society

Nishi,

Goto

2023

Nephron

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Background: Because of the lack of organ donation, living kidney transplantation (LKT) is increasing worldwide. Recently, the number of elderly donors has been increasing, and the patients with end-stage kidney diseases are older than those in the previous decades. Due to the advanced ages, their glomerular filtration rates (GFR) decrease, and the comorbidities such as hypertension, diabetic condition, and obesity are common. The clinicians now have to give their unwilling consent to the LKT from the donors with expanded criteria. Summary: For the secure selection of donors, proper GFR measuring is essential. Although directly measured GFR (mGFR) was recommended in the guidelines, estimated GFR (eGFR) is used at the initial evaluation of donor renal function clinically. Many equations calculating eGFR have been published so far. In the selection of eGFR equations, the smaller difference between mGFR and eGFR and the closer relationship to the prevalence rates of comorbidities are requisite points. Therefore, we compared the specificity of the various eGFR equations. The eGFR calculated from the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation showed approximate reliability with minimal difference between mGFR and eGFR and the closer relationships to the prevalence rates of comorbidities. Key Message: The CKD-EPI-eGFR presented optimal performance in the donor renal function evaluation. Therefore, eGFR from the CKD-EPI equation is highly recommended in evaluating renal function in LKT donors.

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“…However, a recent study reported that kidney donation increased the risk of ESKD by 4-fold compared to that in a matched healthy population (7). Living kidney donation from marginal donors with risk factors for CKD, such as hypertension, glucose intolerance, and obesity, is inevitably increasing (8,9). Therefore, the prediction of post-donation kidney function is important for selecting eligible kidney donors and long-term management after kidney donation.…”

Section: Introductionmentioning

confidence: 99%

Prediction tool for renal adaptation after living kidney donation using interpretable machine learning

Jeon

Song

et al. 2023

Front. Med.

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IntroductionPost-donation renal outcomes are a crucial issue for living kidney donors considering young donors’ high life expectancy and elderly donors’ comorbidities that affect kidney function. We developed a prediction model for renal adaptation after living kidney donation using interpretable machine learning.MethodsThe study included 823 living kidney donors who underwent nephrectomy in 2009–2020. AutoScore, a machine learning-based score generator, was used to develop a prediction model. Fair and good renal adaptation were defined as post-donation estimated glomerular filtration rate (eGFR) of ≥ 60 mL/min/1.73 m2 and ≥ 65% of the pre-donation values, respectively.ResultsThe mean age was 45.2 years; 51.6% were female. The model included pre-donation demographic and laboratory variables, GFR measured by diethylenetriamine pentaacetate scan, and computed tomography kidney volume/body weight of both kidneys and the remaining kidney. The areas under the receiver operating characteristic curve were 0.846 (95% confidence interval, 0.762–0.930) and 0.626 (0.541–0.712), while the areas under the precision-recall curve were 0.965 (0.944–0.978) and 0.709 (0.647–0.788) for fair and good renal adaptation, respectively. An interactive clinical decision support system was developed.1ConclusionThe prediction tool for post-donation renal adaptation showed good predictive capability and may help clinical decisions through an easy-to-use web-based application.

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Metabolic risks in living kidney donors in South Korea

Cited by 6 publications

References 33 publications

Pros and cons of live kidney donation in prediabetics: A critical review and way forward

Pros and cons of live kidney donation in prediabetics: A critical review and way forward

Donor Evaluation of Living Kidney Transplantation in the Aging Society

Prediction tool for renal adaptation after living kidney donation using interpretable machine learning

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