Renal Consequences of Diabetes After Kidney Donation. Issue 12 (14th August 2017)

• Record Type: Journal Article
• Authors: Ibrahim, H. N.; Berglund, D. M.; Jackson, S.; Vock, D. M.; Foley, R. N.; Matas, A. J.
• Is Part Of: American journal of transplantation. Volume 17:Issue 12(2017)
• Page Start: 3141
• Page End: 3148
• Publication Date: 2017-08-14
• Subjects: clinical research/practice -- kidney transplantation/nephrology -- diabetes -- donors and donation: donor follow‐up -- donors and donation: living; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.14416
• Languages: English
• ISSNs: 1600-6135

Abstract

Abstract : Whether diabetes after kidney donation is associated with an accelerated GFR decay in the remaining kidney has not been studied. We determined the incidence of diabetes in kidney donors, and compared GFR change over time in diabetic to nondiabetic donors, in addition to the effect of diabetes mellitus (DM) on the development of proteinuria, hypertension, and end‐stage renal disease (ESRD). Of the 4014 donors, 309 (7.7%) developed diabetes at a median age of 56.0 years and after a median of 18 years after donation. The difference in annual estimated GFR (eGFR) change between diabetic and nondiabetic donors in the 7 years before the development of DM was −0.08 mL/min/year; p = 0.51. After DM development, the difference was −1.10 mL/min/year for diabetic donors with hypertension and proteinuria, p < 0.001; −0.19 for diabetic donors with hypertension but no proteinuria, p = 0.29; −0.75 mL/min/year for diabetic donors with proteinuria but no hypertension, p = 0.19; and −0.09 mL/min/year for diabetic donors without proteinuria or hypertension, p = 0.63. When DM was considered as a time‐dependent covariate, it was associated with the development of proteinuria (hazard ratio [HR] 2.65, 95% confidence interval [CI] 1.89–3.70; p < 0.001) and hypertension (HR 2.19, 95% CI 1.74–2.75; p < 0.001). It was not, however, associated with ESRD. eGFR decline after DM development exceeds that of nondiabetic donors only in diabetic donors with concomitant proteinuria and hypertension. Abstract : A minority of donors develop diabetes after donation, and their rate of GFR change, prevalence of proteinuria, and hypertension is similar to nondonor patients with diabetes.