Impact of screening for metabolic syndrome on the evaluation of obese living kidney donors

Am J Surg. 2018 Jan;215(1):144-150. doi: 10.1016/j.amjsurg.2017.08.019. Epub 2017 Sep 1.

Abstract

Background: We report our experience with metabolic syndrome screening for obese living kidney donor candidates to mitigate the long-term risk of CKD.

Methods: We retrospectively reviewed 814 obese (BMI≥30) and 993 nonobese living kidney donor evaluations over 12 years. Using logistic regression, we explored interactions between social/clinical variables and candidate acceptance before and after policy implementation.

Results: Obese donor candidate acceptance decreased after metabolic syndrome screening began (56.3%, 46.3%, p < 0.01), while nonobese candidate acceptance remained similar (59.6%, 59.2%, p = 0.59). Adjusting for age, gender, race, BMI, and number of prior evaluations, acceptance of obese candidates decreased significantly more than nonobese (p = 0.025). In candidates without metabolic syndrome, there was no significant change in how age, sex, race, or BMI affected a donor candidate's probability of acceptance.

Conclusion: Metabolic syndrome screening is a simple stratification tool for centers with liberal absolute BMI cut-offs to exclude potentially higher-risk obese candidates.

Keywords: Complex kidney donor; Kidney transplant; Living kidney donation; Metabolic syndrome; Obesity.

MeSH terms

  • Adult
  • Donor Selection / methods*
  • Donor Selection / trends
  • Female
  • Humans
  • Kidney Transplantation*
  • Living Donors* / statistics & numerical data
  • Logistic Models
  • Male
  • Metabolic Syndrome / diagnosis*
  • Metabolic Syndrome / epidemiology
  • Metabolic Syndrome / etiology
  • Obesity / complications*
  • Practice Guidelines as Topic
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors