Please use this identifier to cite or link to this item: https://doi.org/10.1007/s00345-018-2566-2
Title: Visceral obesity in Asian living kidney donors significantly impacts early renal function after donor nephrectomy
Authors: Pek, Gregory Xiang Wen
Ngoh, Clara Lee Ying
Teo, Boon Wee
Vathsala, Anantharaman
Goh, Benjamin Yen Seow
Yong, Clement Hsiang Rong
Raman, Lata
Tiong, Ho Yee 
Keywords: Science & Technology
Life Sciences & Biomedicine
Urology & Nephrology
Visceral obesity
Obesity
Nephrectomy
Donor
Donor nephrectomy
Transplantation
Chronic kidney disease
CKD
CKD-EPI
ABDOMINAL FAT
RISK-FACTORS
DISEASE
ACCUMULATION
ASSOCIATION
EXPRESSION
JAPANESE
Issue Date: 1-Oct-2019
Publisher: SPRINGER
Citation: Pek, Gregory Xiang Wen, Ngoh, Clara Lee Ying, Teo, Boon Wee, Vathsala, Anantharaman, Goh, Benjamin Yen Seow, Yong, Clement Hsiang Rong, Raman, Lata, Tiong, Ho Yee (2019-10-01). Visceral obesity in Asian living kidney donors significantly impacts early renal function after donor nephrectomy. WORLD JOURNAL OF UROLOGY 37 (10) : 2231-2236. ScholarBank@NUS Repository. https://doi.org/10.1007/s00345-018-2566-2
Abstract: Introduction: Obesity may be a risk factor for kidney donors to develop reduced renal function. The Framingham heart study suggested that visceral adipose tissue (VAT) confers a more adverse metabolic profile compared with subcutaneous adipose tissue (SAT). Asians tend to have a higher VAT composition and it is unclear if their kidney function is affected differently. We hypothesized that Asian living kidney donors who have visceral obesity are at a higher risk of renal function deterioration 1 year after donation. Methods: Between 2011 and 2014, we retrospectively evaluated data from 73 consecutive patients (52% male; mean age 44.9 ± 11.7 years) before they underwent donor nephrectomy and at their 1 year routine follow-up. VAT and SAT were measured at the level of the umbilicus on pre-operative computerized tomography (CT). Visceral obesity (VO) was defined as a VAT > 100 cm [2] and patients were then further divided and compared in two subgroups: VAT > 100 and < 100 cm [2]. Estimated glomerular filtration rate (eGFR, mL/min per 1.73 m [2]) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation pre-operatively and 1 year post-operatively. Results: Both subgroups had similar baseline kidney function (P = NS) pre-operatively. At the 1 year follow-up, patients with VO experienced a more significant decline of renal function (109 ± 9 to 89 ± 8 mL/min per 1.73 m2), compared to those without VO (111 ± 12 to 96 ± 11 mL/min per 1.73 m2, P = 0.013). VO was associated with a body mass index (BMI) > 25 kg/m2 (P < 0.001), male gender (P < 0.001) and older age at the time of donor nephrectomy (48.0 vs 39.5 years, P = 0.01). The presence of hypertension or hyperlipidaemia pre-operatively, choice of surgical approach, and post-operative complication rates, did not differ significantly between the subgroups. Conclusions: Visceral obesity as defined by VAT > 100 cm2 at the level of the umbilicus on cross-sectional imaging, may have a significant impact on early renal function after donor nephrectomy. Adiposity markers, as measured by cross-sectional CT imaging, may be incorporated into routine pre-operative kidney donor workup.
Source Title: WORLD JOURNAL OF UROLOGY
URI: https://scholarbank.nus.edu.sg/handle/10635/217018
ISSN: 0724-4983
1433-8726
DOI: 10.1007/s00345-018-2566-2
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