Westenberg, L.B. (Lisa) (2019) The Effect of Variations in Body Composition on Surgical Complications and Long-Term Renal Function after Living Kidney Donation. thesis, Medicine.
Full text available on request.Abstract
Background: Obesity is considered a risk factor for surgical complications and developing renal failure. Little is known about surgical complications and renal failure in overweight living kidney donors. The aim of this study is to assess the risk of complications and renal failure following living donor nephrectomy using different measures of body composition. Methods: We included 1150 living kidney donors who donated between 1980 and 2018 at the University Medical Centre Groningen. Pre-nephrectomy measures of body composition were body mass index (BMI), body surface area (BSA), waist circumference, weight, and waist-hip ratio. Surgical complications were assessed using the Comprehensive Complication Index. Post-donation renal function was assessed using measured glomerular filtration rate (mGFR) at 5 and 10 years follow-up. Results: Mean donor age was 52 ± 11 years, 553 (47.7%) were male and median mGFR predonation was 113.5 ± 21.8 mL/min*1.73m2. Baseline mGFR was higher in obese (BMI>30) donors compared to non-obese donors (respectively 121.6 ± 23.7 vs. 108.0 ± 19.5, p<0.001). At 5 years, BMI (β=0.21, p<0.001), BSA (β=0.55, p<0.001), female waist circumference (β=0.31, p<0.001), weight (β=0.48, p<0.001) and female waist-hip ratio (β=0.16, p=0.03) were associated with increased mGFR. At 10 years, BMI (β=0.22, p=0.01), BSA (β=0.45, p<0.001), female waist circumference (β=0.36, p=0.02) and weight (β=0.41, p<0.001) were associated with mGFR. In multivariable analysis, female waist-hip ratio was associated with increased delta mGFR between 2 months and 5 years after nephrectomy (β=0.17, p=0.03). No body measure was significantly associated with surgical complications. Conclusion: This study shows that overweight living kidney donors have increased mGFR at 5 and 10 years post-nephrectomy, which may be an overestimation due to a supraphysiologic elevation in GFR in obese patients. Higher female waist-hip ratio is associated with less decrease in mGFR between 2 months and 5 years post-nephrectomy. These data can be used during donor screening and in donor education.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty supervisor: and Bakker, Prof. Dr. S.J.L. and Second supervisor: and Pol, Dr R.A. and Location: and University Medical Center Groningen and Department of Internal Medicine, Division of Nephrology and Department of Surgery and Division of Transplantation Surgery |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:52 |
| Last Modified: | 25 Jun 2020 10:52 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1280 |
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