REVIEW ARTICLE


Long-Term Kidney Outcomes in High BMI Living Kidney Donors: A Narrative Review



Kalyani Murthy*, 1, 2, Hannah Caldwell1, Mary A. Simpson3
1 Department of General Internal Medicine, Lahey Hospital & Medical Center, Burlington, MA, USA
2 Associate Clinical Professor, Tufts University School of Medicine, Boston, MA, USA
3 Director, Clinical Research & Education (Transplantation), Lahey Hospital & Medical Center, Burlington, MA, USA


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© 2017 Kalyani Murthy.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of General Internal Medicine, Lahey Hospital and Medical Center, 41 Mall Road, Burlington, MA, 01805, USA; Tel: 7817441956; Fax: 7817445372; E-mail: Kalyani.Murthy@Lahey.org


Abstract

Background:

The shortage of transplantable organs has led to the expansion of the living kidney donor (LKD) pool to include overweight (body mass index [BMI] 25-30 kg/m2) and obese (BMI ≥30 kg/m2) donors. Higher BMI is a known risk factor for chronic kidney disease and progression to end-stage renal disease.

Methods & Materials:

We focused our review on long-term kidney-related outcomes (kidney function, hypertension, and proteinuria) among higher BMI LKDs. A PubMed search retrieved a total of 27 articles reporting on renal outcomes for obese LKDs. Of these, nine studies with ≥5 years of follow-up were selected for inclusion.

Results:

Five studies reported a decrease in kidney function at follow-up for higher BMI LKDs. Higher BMI was noted as a risk factor for hypertension in six studies. Proteinuria was reported in six studies, and a significant association was noted with higher BMI status in three.

Conclusion:

This review highlights the continued need for long-term documentation of kidney function and related outcomes in higher BMI LKDs.

Keywords: living kidney donors, obesity, overweight, kidney function, chronic kidney disease, hypertension.