Metabolic outcomes still occur, but kidney donation is obviously safe
Malek Mojaat1, Manel Ben Salah1, Mariem Ben Salem1, Insaf Handous1, Mouna Hamouda1, Ahmed Letaief1, Sabra Aloui1, Habib Skhiri1.
1Nephrology, dialysis and kidney transplantation, Fattouma Bourguiba University Hospital, Monastir, Tunisia
Introduction: Living kidney donation is the treatment of choice for end-stage kidney disease as it offers numerous advantages for the recipient. However, many questions regarding the prognosis of the living donor and namely the risk for metabolic complications have arisen and many studies provided reassuring results.
Methods: This is a retrospective, mono-centric, descriptive and analytical study reporting metabolic outcomes among 40 living donors who were admitted to our kidney transplantation center. The donors were followed-up in our consultation after discharge. During each visit, clinical and biological data were recorded and evaluated.
Results: Median follow-up was 9 years. The median age was 42 years.75% were female.62% were married.80% of donors were related to the recipient. One donor had a history of hypertension well-controlled on monotherapy. Pre donation work-up showed that the Median Body mass index (BMI) prior to donation was 23,22 kg/m2. Four donors had obesity and seven others had overweight. The median of cholesterol and triglyceride were 4,53 and 0,91 mmol/l respectively and that of uric acid was 231 umol/l. The median time of hospitalization was 5 days. During follow-up, and comparatively, with pre-donation assessment, we noted a slight increase in the median of BMI at short and mid-terms that did not reach significance (p>0,05). We observed a significant increase in triglyceride levels at mid and long-term follow-up reaching 1.13 and 0.93 mmol/l respectively (p<0,05). The cholesterol curve after donation described an oscillating aspect with a significant difference only at mid-term reaching 4.83 mmol/l (p=0,03). Seven donors developed dyslipidemia requiring treatment with statins. Uric acid levels increased significantly from baseline at one year and stabilized at that threshold thereafter (p<0,05). Hyperuricemia was observed in six patients of whom one patient developed gout.
Conclusion: Our results show that kidney donation is safe provided that a meticulous screening is performed prior to donation. Metabolic outcomes could occur after kidney donation, thus regular follow-up and prompt management would help to prevent harm.
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