Association of the Metabolic Syndrome and Long-Term Renal
Function in Kidney Donors
D. Cuevas-Ramos, P. Almeda-Valdés, M. Arvizu, J. Mata, L.E. Morales-Buenrostro, B. Gabilondo,
M. Vilatobá, R. Correa-Rotter, F. Gabilondo-Navarro, R. Mehta, C.A. Aguilar-Salinas, J. Alberú, and
F.J. Gómez-Pérez
ABSTRACT
Background. Metabolic syndrome (MetS) may represent risk factor for long-term renal
function of kidneys from living donors. The aim of this study was to evaluate the impact
of MetS on renal function in donors.
Methods. Data regarding the presence or absence of MetS and renal function, as
assessed by estimated glomerular filtration rate (eGFR) were obtained from 140 kidney
donors before nephrectomy (BN) and at follow-up (AF). Donors were divided into those
with (group 1; n =28) versus without MetS (group 2; n = 112).
Results. Comparing the groups, we observed a significantly greater reduction in eGFR
among the group with MetS BN versus AF 27.5% (19.3–33.0) versus 21.4% (9.6 –34.1 P =
.02) respectively using a Cox regression model, including age, gender, serum uric acid,
body mass index (BMI), and basal eGFR, MetS BN (hazard ratio = 2.2; 95% confidence
interval [CI], 1.21– 4.01; p = .01) was an independent factor associated with a greater risk
of a-eGFR 70 mL/min/1.73 m
2
at follow-up ( P .001). Additionally, age (hazard ratio =
1.03%; 95% CI, 1.01–1.06; P .001), and female gender (hazard ratio = 1.86; 95% CI,
1.03–3.36; P = .03) were associated with a greater decrease in eGFR. Individuals with MetS
BN showed a GFR 70 mL/min/1.73 m
2
at significantly shorter follow-up time (5.6 0.8
years) versus persons without MetS (12.8 1.0 years; P = .001)
Conclusion. Kidney donors with MetS BN experiment a significantly greater decrease in
eGFR at follow-up.
L
IVING kidney donation has increased worldwide. It
partially alleviates the shortage of kidney allografts.
1
A graft obtained by living kidney donation is superior in
terms of short-term and long-term graft survival and func-
tion compared with one obtained from a decreased donor.
2
For appropriately selected living kidney donors, the proce-
dure does not appear to negatively impact long-term out-
comes of the remaining kidney.
3–5
After donation renal
function as assessed by measured or estimated glomerular
filtration rate (eGFR) has been observed to be about 70%
of the prenephrectomy values. It decreases with age no
faster than among persons with both kidneys.
6
However,
some studies have shown that 10% of donors develop lower
than expected GFR levels after nephrectomy; such donors
show 50% decrease in GFR over the 10 years after
donation.
7,8
Many risk factors have been suggested to
explain this phenomenon. The most constant findings have
been older age
5,9
and higher body mass index (BMI).
5
Other
factors, such as hyperglycemia,
10
gender, and hyperten-
sion,
7–9
have not been consistently associated with a lower
From the Departments of Endocrinology and Metabolism
(D.C.-R., P.A.-V., J.M., R.M., C.A.A.-S., F.J.G.-P.), Transplanta-
tion (M.A., L.E.M.-B., B.G., M.V., J.A.), Nephrology and Mineral
Metabolism (L.E.M.-B., R.C.-R.), and Urology, (B.G., F.G.-N.)
Instituto Nacional de Ciencias Médicas y Nutrición Salvador
Zubirán Mexico City, Mexico.
J.A. and F.J.G.P. equally contributed to the study design and
manuscript review as senior co-authors.
Address correspondence to: Francisco J. Gómez-Pérez, De-
partment of Endocrinology and Metabolism, and Josefina Alberú
(josefinaalberu@hotmail.com), Department of Transplantation.
Instituto Nacional de Ciencias Médicas y Nutrición Salvador
Zubirán. Vasco de Quiroga 15, Tlalpan 14000, México, D.F.,
México. E-mail: fcojgomezp@aol.com
© 2011 by Elsevier Inc. All rights reserved. 0041-1345/–see front matter
360 Park Avenue South, New York, NY 10010-1710 doi:10.1016/j.transproceed.2011.02.058
Transplantation Proceedings, 43, 1601–1606 (2011) 1601