Progression and new onset of nonalcoholic fatty liver disease in living kidney donors compared to healthy controls

Katchman, Helena; Zelber‐Sagi, Shira; Baruch, Roni; Berman, Galia; Schwartz, Idit F.; Schwartz, Doron; Nakache, Richard; Goykhman, Yaacov; Katz, Paulina; Shibolet, Oren; Shashar, Moshe; Grupper, Ayelet

doi:10.1111/ctr.13240

Cited by 2 publications

(3 citation statements)

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“…There is little evidence to support routine stress testing in asymptomatic adults; however, stress testing continues to be frequently performed routinely in donor candidates who are older, or have cardiovascular risk factors regardless of their functional assessment 37 . The impact of various isolated cardiac abnormalities detected on echocardiography or electrocardiogram on long‐term outcomes in the donors, if any, is not known.…”

Section: Discussionmentioning

confidence: 99%

“…Although donor candidates with severe hypertension and diabetes are routinely excluded, we presume transplant programs are encountering hepatic steatosis more frequently in this population (eg, as an incidental finding on abdominal imaging). Data on impact of NAFLD on donor outcomes is just beginning to emerge,36 and our survey shows that programs are generally excluding such candidates if LFT elevations, fibrosis, or other metabolic abnormalities are noted.There is little evidence to support routine stress testing in asymptomatic adults; however, stress testing continues to be frequently performed routinely in donor candidates who are older, or have cardiovascular risk factors regardless of their functional assessment 37.…”

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confidence: 99%

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Metabolic, cardiovascular, and substance use evaluation of living kidney donor candidates: US practices in 2017

Garg

Lentine

Inker

et al. 2020

American Journal of Transplantation

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We surveyed US transplant centers to assess practices regarding the evaluation and selection of living kidney donors based on metabolic, cardiovascular, and substance use risk factors. Our companion article describes renal aspects of the evaluation. Response rate was 31%. Compared with 2005, programs have become more accepting of hypertensive candidates: 65% in 2017% vs 41% in 2005 consider candidates with hypertension well controlled with 1 medication. One notable exception is black hypertensive candidates, who are frequently excluded regardless of severity. The most common body mass index (BMI) cutoff remains 35 kg/m 2 , and fewer programs now consider candidates with BMI >40 kg/m 2. A 2-hour oral glucose tolerance test of ≥140 mg/dL remains the most common criterion for exclusion of prediabetic candidates. One quarter to one third of programs exclude based on isolated cardiac abnormalities, such as mild aortic stenosis; a similar proportion consider these candidates only if older than 50 years. Cigarette or marijuana smoking are infrequently criteria for exclusion, although 45% and 37% programs, respectively, require cessation 4 weeks prior to surgery. In addition to providing an overview of current practices in living kidney donor evaluation, our study highlights the importance of research evaluating outcomes with various comorbidities to guide practice.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Metabolic, cardiovascular, and substance use evaluation of living kidney donor candidates: US practices in 2017

Garg

Lentine

Inker

et al. 2020

American Journal of Transplantation

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“…Living kidney donors do not have underlying kidney disease but have reduced GFR as a result of nephrectomy. However, a study reported that reduced kidney function after kidney donation is not associated with increased incidence or progression of NAFLD[ 130 ], but that data on prediabetic kidney donors is lacking. Looking at data from the general population, it will be interesting to evaluate the association between NAFLD and PD in kidney donors.…”

Section: Is Ckd the Only Concern Of Pd?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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Progression and new onset of nonalcoholic fatty liver disease in living kidney donors compared to healthy controls

Abstract: Reduced kidney function secondary to kidney donation is not associated with increased incidence or progression of NAFLD.

Cited by 2 publications

References 49 publications

Metabolic, cardiovascular, and substance use evaluation of living kidney donor candidates: US practices in 2017

Metabolic, cardiovascular, and substance use evaluation of living kidney donor candidates: US practices in 2017

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

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