Bosch, S.A.S. van den (Sascha) (2021) The effect of HbA1c values pre-donation in kidney donors on kidney function post-donation. thesis, Medicine.
Full text available on request.Abstract
Background Currently, kidney donor candidates with diabetes, defined as an HbA1c value above 53 mmol/mol or fasting glucose above 7 mmol/L, are rejected for donation. Diabetes mellitus is recognized as a significant risk factor for developing kidney damage with proteinuria post-donation. Several studies have shown that an high-normal HbA1c value also increases the risk of proteinuria in the general population but data in kidney donor candidates is sparse. Therefore, in this study we investigate the association between pre-donation HbA1c and proteinuria five years post-donation. Method In this longitudinal cohort study, data on HbA1c, kidney function and proteinuria was collected from 311 living kidney donors that participated in the TransplantLines study between 1999 and 2017. A linear regression analysis was performed with HbA1c before donation as independent variable and proteinuria 5 years after donation as outcome. In a multivariable model, adjustments were made for possible confounders. Results Of the 311 donors (age 50.5 ± 10.3 years, 56.3% female) 73 (23.4%) developed proteinuria after 5 years. At baseline, 105 (33.8%) had prediabetes, the mean HbA1c was 36.7± 4.2 mmol/mol. The mean protein excretion after 5 years was 0.12 (0.11) mg/24h. HbA1c pre-donation was associated with proteinuria 5 years after donation (st. Β 0.209, P < 0.001). Adjusting for gender, age, BMI, systolic blood pressure, diastolic blood pressure and mGFR did not result in a different outcome. De pre-donation HbA1c was not associated with kidney function,years after donation (St. β -0.072, P=0.21). Conclusion A positive association was found between the HbA1c value measured during screening and proteinuria 5 years after donation. The follow-up time should be extended to investigate in a larger sample size whether the donors with proteinuria actually develop more kidney damage than the donors without proteinuria.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Borst, prof. dr. M. de and Londen, dr. M. van |
| Faculty: | Medical Sciences |
| Date Deposited: | 05 Jan 2022 11:00 |
| Last Modified: | 05 Jan 2022 11:00 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2941 |
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