Assess Donors For Metabolic Syndrome

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SAN DIEGO—Individuals who donate one of their kidneys experience a faster deterioration of their other kidney if they have metabolic syndrome at the time of donation, according to new study data presented at The Endocrine Society's 92nd Annual Meeting.

“Kidney donors should be assessed for metabolic syndrome and once metabolic abnormalities are identified they should be corrected before nephrectomy and the kidney donors should be evaluated in the future very closely,” said lead investigator Daniel Cuevas-Ramos, MD, an endocrinologist and diabetologist and a clinical researcher at Mexico's Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran in Mexico City.

Diagnosis of metabolic syndrome depends on the presence of at least three of the following: a large waistline, low HDL cholesterol, high triglycerides, high BP, and high blood glucose at a level considered prediabetes or above.  The metabolic syndrome, which affects one in five people in the United States, increases the risk of developing type 2 diabetes, heart disease, and stroke.

Dr. Cuevas-Ramos and his colleagues studied 140 living adults who donated a kidney. Of those, 28 donors had metabolic syndrome before donation and 112 did not.  Using long-term follow-up data, the investigators determined each donor's kidney function after donation, based on estimated glomerular filtration rate (eGFR). For this study, an eGFR of 70 mL/min/1.73 m2 or less was considered below-normal kidney function.

The average time it took for donor's eGFR to drop below 70 was 5.6 years among those had metabolic syndrome before donation compared with about 12.8 years in donors without the syndrome. In addition to metabolic syndrome, age, female gender, elevated uric acid levels, and metabolic syndrome were independently associated with an increased risk for developing an eGFR of 70 or below.

“We do not intend to imply that metabolic syndrome is a contraindication for kidney donation.  However, we believe that ideally any metabolic abnormality detected before nephrectomy should be corrected and donors should remain under strict metabolic surveillance after donation,” Dr. Cuevas-Ramos said.

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