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Published in: Clinical and Experimental Nephrology 4/2011

01-08-2011 | Original Article

Kidney function, albuminuria and cardiovascular risk factors in post-operative living kidney donors: a single-center, cross-sectional study

Authors: Masahiko Yazawa, Ryo Kido, Yugo Shibagaki, Takashi Yasuda, Ryuto Nakazawa, Hideo Sasaki, Yuichi Sato, Tatsuya Chikaraishi, Kenjiro Kimura

Published in: Clinical and Experimental Nephrology | Issue 4/2011

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Abstract

Background

Mortality and renal or cardiovascular prognosis in living kidney donors (LKDs) has been reported to be as same as the general population; however, it is known that the prevalence of hypertension, albuminuria and metabolic syndrome increases after donation. At present, data from Japanese donors are scarce and as a result the actual medical status of LKDs remains unclear. To evaluate cardiovascular disease (CVD) risk factors in Japanese LKDs, we conducted a cross-sectional study on LKDs at our tertiary care hospital and clinic.

Method

Thirty-six out of 63 LKDs who underwent kidney donation at the kidney disease center of the St. Marianna University Hospital were enrolled. The kidney function, albuminuria, and CVD risk factors including hypertension, dyslipidemia, hyperuricemia, glucose intolerance (GI) and obesity were cross-sectionally investigated.

Results

The kidney function by inulin clearance was 55.2 ± 10.3 ml/min/1.73 m2 on average, indicating that 63.9% of LKDs were categorized into chronic kidney disease (CKD) stage 3 after donation. Albuminuria developed in 16.7%. Blood pressure (BP) was not elevated after donation, but ambulatory BP monitoring revealed that 39.4% of LKDs were categorized as having non-dipper type BP. GI was shown in 25% of LKDs. Prevalence of dyslipidemia and hyperuricemia were 41.7% and 27.8%, respectively. Body mass index was not significantly changed after donation. Seven LKDs (19.4%) were diagnosed with metabolic syndrome.

Conclusion

Many Japanese LKDs were experiencing decreased kidney function corresponding to CKD stage 3. They also had a significant but not lower prevalence of albuminuria and CVD risk compared to the general Japanese population. LKDs should be followed closely with special attention to the management of renal and CVD risk factors.
Literature
1.
go back to reference Horvat LD, Shariff SZ, Garg AX. Global trends in the rates of living kidney donation. Kidney Int. 2009;75:1088–98.CrossRefPubMed Horvat LD, Shariff SZ, Garg AX. Global trends in the rates of living kidney donation. Kidney Int. 2009;75:1088–98.CrossRefPubMed
2.
go back to reference The Japanese Society for Clinical Renal Transplantation. Annual Progress Report from Japanese Renal Transplant Registry: Number of Renal Transplantation in 2008, part 2. Isyoku. 2009;44:548–58 (in Japanese). The Japanese Society for Clinical Renal Transplantation. Annual Progress Report from Japanese Renal Transplant Registry: Number of Renal Transplantation in 2008, part 2. Isyoku. 2009;44:548–58 (in Japanese).
4.
go back to reference Segev DL, Muzaale AD, Caffo BS, Mehta SH, Singer AL, Taranto SE, et al. Perioperative mortality and long-term survival following live kidney donation. JAMA. 2010;303:959–66.CrossRefPubMed Segev DL, Muzaale AD, Caffo BS, Mehta SH, Singer AL, Taranto SE, et al. Perioperative mortality and long-term survival following live kidney donation. JAMA. 2010;303:959–66.CrossRefPubMed
5.
go back to reference Fehrman-Ekholm I, Elinder CG, Stenbeck M, Tyden G, Groth CG. Kidney donors live longer. Transplantation. 1997;64:976–8.CrossRefPubMed Fehrman-Ekholm I, Elinder CG, Stenbeck M, Tyden G, Groth CG. Kidney donors live longer. Transplantation. 1997;64:976–8.CrossRefPubMed
6.
go back to reference Garg AX, Prasad GV, Thiessen-Philbrook HR, Ping L, Melo M, Gibney EM, Donor Nephrectomy Outcomes Research (DONOR) Network, et al. Cardiovascular disease and hypertension risk in living kidney donors: an analysis of health administrative data in Ontario, Canada. Transplantation. 2008;86:399–406.CrossRefPubMed Garg AX, Prasad GV, Thiessen-Philbrook HR, Ping L, Melo M, Gibney EM, Donor Nephrectomy Outcomes Research (DONOR) Network, et al. Cardiovascular disease and hypertension risk in living kidney donors: an analysis of health administrative data in Ontario, Canada. Transplantation. 2008;86:399–406.CrossRefPubMed
7.
go back to reference Okamoto M, Akioka K, Nobori S, Ushigome H, Kozaki K, Kaihara S, et al. Short- and long-term donor outcomes after kidney donation: analysis of 601 cases over a 35-year period at Japanese single center. Transplantation. 2009;87:419–23.CrossRefPubMed Okamoto M, Akioka K, Nobori S, Ushigome H, Kozaki K, Kaihara S, et al. Short- and long-term donor outcomes after kidney donation: analysis of 601 cases over a 35-year period at Japanese single center. Transplantation. 2009;87:419–23.CrossRefPubMed
8.
go back to reference Kido R, Shibagaki Y, Iwadoh K, Nakajima I, Fuchinoue S, Fujita T, et al. How do living kidney donors develop end-stage renal disease? Am J Transplant. 2009;9:2514–9.CrossRefPubMed Kido R, Shibagaki Y, Iwadoh K, Nakajima I, Fuchinoue S, Fujita T, et al. How do living kidney donors develop end-stage renal disease? Am J Transplant. 2009;9:2514–9.CrossRefPubMed
9.
go back to reference Boudville N, Prasad GV, Knoll G, Muirhead N, Thiessen-Philbrook H, Yang RC, Donor Nephrectomy Outcomes Research (DONOR) Network, et al. Meta-analysis: risk for hypertension in living kidney donors. Ann Intern Med. 2006;145:185–96.CrossRefPubMed Boudville N, Prasad GV, Knoll G, Muirhead N, Thiessen-Philbrook H, Yang RC, Donor Nephrectomy Outcomes Research (DONOR) Network, et al. Meta-analysis: risk for hypertension in living kidney donors. Ann Intern Med. 2006;145:185–96.CrossRefPubMed
10.
go back to reference Garg AX, Muirhead N, Knoll G, Yang RC, Prasad GV, Thiessen-Philbrook H, Donor Nephrectomy Outcomes Research (DONOR) Network, et al. Proteinuria and reduced kidney function in living kidney donors: a systematic review, meta-analysis, and meta-regression. Kidney Int. 2006;70:1801–10.CrossRefPubMed Garg AX, Muirhead N, Knoll G, Yang RC, Prasad GV, Thiessen-Philbrook H, Donor Nephrectomy Outcomes Research (DONOR) Network, et al. Proteinuria and reduced kidney function in living kidney donors: a systematic review, meta-analysis, and meta-regression. Kidney Int. 2006;70:1801–10.CrossRefPubMed
11.
go back to reference Rizvi SA, Naqvi SA, Jawad F, Ahmed E, Asghar A, Zafar M, et al. Living kidney donor follow-up in a dedicated clinic. Transplantation. 2005;79:1247–51.CrossRefPubMed Rizvi SA, Naqvi SA, Jawad F, Ahmed E, Asghar A, Zafar M, et al. Living kidney donor follow-up in a dedicated clinic. Transplantation. 2005;79:1247–51.CrossRefPubMed
12.
go back to reference Kuzuya T, Nakagawa S, Satoh J, Kanazawa Y, Iwamoto Y, Kobayashi M, et al. Committee of the Japan Diabetes Society on the diagnostic criteria of diabetes mellitus. Report of the Committee on the classification and diagnostic criteria of diabetes mellitus. Diabetes Res Clin Pract. 2002;55:65–85.CrossRefPubMed Kuzuya T, Nakagawa S, Satoh J, Kanazawa Y, Iwamoto Y, Kobayashi M, et al. Committee of the Japan Diabetes Society on the diagnostic criteria of diabetes mellitus. Report of the Committee on the classification and diagnostic criteria of diabetes mellitus. Diabetes Res Clin Pract. 2002;55:65–85.CrossRefPubMed
13.
go back to reference National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002;39:S1–266. National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002;39:S1–266.
14.
go back to reference Horio M, Yasuda Y, Takahara S, Imai E, Watanabe T, Matsuo S. Comparison of a simple and a standard method for inulin renal clearance. Clin Exp Nephrol. 2010;14(5):427–30.CrossRefPubMed Horio M, Yasuda Y, Takahara S, Imai E, Watanabe T, Matsuo S. Comparison of a simple and a standard method for inulin renal clearance. Clin Exp Nephrol. 2010;14(5):427–30.CrossRefPubMed
15.
go back to reference Horio M, Imai E, Yasuda Y, Hishida A, Matsuo S, Japanese Equation for Estimating GFR. Simple sampling strategy for measuring inulin renal clearance. Clin Exp Nephrol. 2009;13:50–4.CrossRefPubMed Horio M, Imai E, Yasuda Y, Hishida A, Matsuo S, Japanese Equation for Estimating GFR. Simple sampling strategy for measuring inulin renal clearance. Clin Exp Nephrol. 2009;13:50–4.CrossRefPubMed
16.
go back to reference Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, et al. Collaborators developing the Japanese equation for estimated GFR. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis. 2009;53:982–92.CrossRef Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, et al. Collaborators developing the Japanese equation for estimated GFR. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis. 2009;53:982–92.CrossRef
17.
go back to reference Matsuzawa Y. Metabolic syndrome-definition and diagnostic criteria in Japan. J Jpn Soc Med. 2005;94:188–203. Matsuzawa Y. Metabolic syndrome-definition and diagnostic criteria in Japan. J Jpn Soc Med. 2005;94:188–203.
18.
go back to reference Hakoda M. Epidemiology of hyperuricemia and gout in Japan. Nippon Rinsho. 2008;66:647–52 (in Japanese).PubMed Hakoda M. Epidemiology of hyperuricemia and gout in Japan. Nippon Rinsho. 2008;66:647–52 (in Japanese).PubMed
19.
go back to reference Kido R, Shibagaki Y, Iwadoh K, Nakajima I, Fuchinoue S, Fujita T, et al. Very low but stable glomerular filtration rate after living kidney donation: is the concept of “chronic kidney disease” applicable to kidney donors? Clin Exp Nephrol. 2010;14:356–62.CrossRefPubMed Kido R, Shibagaki Y, Iwadoh K, Nakajima I, Fuchinoue S, Fujita T, et al. Very low but stable glomerular filtration rate after living kidney donation: is the concept of “chronic kidney disease” applicable to kidney donors? Clin Exp Nephrol. 2010;14:356–62.CrossRefPubMed
20.
go back to reference Kakuta Y, Okumi M, Ichimaru N, Abe T, Nonomura N, Okuyama A, et al. Utility of the Japanese GFR estimation equation for evaluating potential donor kidney function. Clin Exp Nephrol. 2010;14:63–7.CrossRefPubMed Kakuta Y, Okumi M, Ichimaru N, Abe T, Nonomura N, Okuyama A, et al. Utility of the Japanese GFR estimation equation for evaluating potential donor kidney function. Clin Exp Nephrol. 2010;14:63–7.CrossRefPubMed
21.
go back to reference Tan JC, Ho B, Busque S, Blouch K, Derby G, Efron B, et al. Imprecision of creatinine-based GFR estimates in uninephric kidney donors. Clin J Am Soc Nephrol. 2010;5:497–502.CrossRefPubMedPubMedCentral Tan JC, Ho B, Busque S, Blouch K, Derby G, Efron B, et al. Imprecision of creatinine-based GFR estimates in uninephric kidney donors. Clin J Am Soc Nephrol. 2010;5:497–502.CrossRefPubMedPubMedCentral
22.
go back to reference Imai E. Equation for estimating GFR from creatinine in Japan. Nippon Rinsho. 2008;66:1725–9 (in Japanese).PubMed Imai E. Equation for estimating GFR from creatinine in Japan. Nippon Rinsho. 2008;66:1725–9 (in Japanese).PubMed
24.
go back to reference Imai E, Horio M, Yamagata K, Iseki K, Hara S, Ura N, et al. Slower decline of glomerular filtration rate in the Japanese general population: a longitudinal 10-year follow-up study. Hypertens Res. 2008;31:433–41.CrossRefPubMed Imai E, Horio M, Yamagata K, Iseki K, Hara S, Ura N, et al. Slower decline of glomerular filtration rate in the Japanese general population: a longitudinal 10-year follow-up study. Hypertens Res. 2008;31:433–41.CrossRefPubMed
25.
go back to reference Iseki K, Kinjo K, Iseki C, Takishita S. Relationship between predicted creatinine clearance and proteinuria and the risk of developing ESRD in Okinawa, Japan. Am J Kidney Dis. 2004;44:806–14.CrossRefPubMed Iseki K, Kinjo K, Iseki C, Takishita S. Relationship between predicted creatinine clearance and proteinuria and the risk of developing ESRD in Okinawa, Japan. Am J Kidney Dis. 2004;44:806–14.CrossRefPubMed
26.
go back to reference Nakayama M, Metoki H, Terawaki H, Ohkubo T, Kikuya M, Sato T, et al. Kidney dysfunction as a risk factor for first symptomatic stroke events in a general Japanese population—the Ohasama study. Nephrol Dial Transplant. 2007;22:1910–5.CrossRefPubMed Nakayama M, Metoki H, Terawaki H, Ohkubo T, Kikuya M, Sato T, et al. Kidney dysfunction as a risk factor for first symptomatic stroke events in a general Japanese population—the Ohasama study. Nephrol Dial Transplant. 2007;22:1910–5.CrossRefPubMed
27.
go back to reference Konta T, Hao Z, Abiko H, Ishikawa M, Takahashi T, Ikeda A, et al. Prevalence and risk factor analysis of microalbuminuria in Japanese general population: the Takahata study. Kidney Int. 2006;70:751–6.CrossRefPubMed Konta T, Hao Z, Abiko H, Ishikawa M, Takahashi T, Ikeda A, et al. Prevalence and risk factor analysis of microalbuminuria in Japanese general population: the Takahata study. Kidney Int. 2006;70:751–6.CrossRefPubMed
28.
go back to reference Ogihara T, Kikuchi K, Matsuoka H, Fujita T, Higaki J, Horiuchi M, Japanese Society of Hypertension Committee, et al. The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2009). Hypertens Res. 2009;32:3–107.PubMed Ogihara T, Kikuchi K, Matsuoka H, Fujita T, Higaki J, Horiuchi M, Japanese Society of Hypertension Committee, et al. The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2009). Hypertens Res. 2009;32:3–107.PubMed
29.
go back to reference Ohkubo T, Hozawa A, Yamaguchi J, Kikuya M, Ohmori K, Michimata M, et al. Prognostic significance of the nocturnal decline in blood pressure in individuals with and without high 24-h blood pressure: the Ohasama study. J Hypertens. 2002;20:2183–9.CrossRefPubMed Ohkubo T, Hozawa A, Yamaguchi J, Kikuya M, Ohmori K, Michimata M, et al. Prognostic significance of the nocturnal decline in blood pressure in individuals with and without high 24-h blood pressure: the Ohasama study. J Hypertens. 2002;20:2183–9.CrossRefPubMed
30.
go back to reference Hoshide S, Kario K, Hoshide Y, Umeda Y, Hashimoto T, Kunii O, et al. Associations between nondipping of nocturnal blood pressure decrease and cardiovascular target organ damage in strictly selected community-dwelling normotensives. Am J Hypertens. 2003;16:434–8.CrossRefPubMed Hoshide S, Kario K, Hoshide Y, Umeda Y, Hashimoto T, Kunii O, et al. Associations between nondipping of nocturnal blood pressure decrease and cardiovascular target organ damage in strictly selected community-dwelling normotensives. Am J Hypertens. 2003;16:434–8.CrossRefPubMed
31.
go back to reference Eberhard OK, Kliem V, Offner G, Oldhafer K, Fangmann J, Pichlmay R, et al. Assessment of long-term risks for living related kidney donors by 24-h blood pressure monitoring and testing for microalbuminuria. Clin Transplant. 1997;11:415–9.PubMed Eberhard OK, Kliem V, Offner G, Oldhafer K, Fangmann J, Pichlmay R, et al. Assessment of long-term risks for living related kidney donors by 24-h blood pressure monitoring and testing for microalbuminuria. Clin Transplant. 1997;11:415–9.PubMed
32.
go back to reference Fukuda M, Goto N, Kimura G. Hypothesis on renal mechanism of non-dipper pattern of circadian blood pressure rhythm. Med Hypotheses. 2006;67:802–6.CrossRefPubMed Fukuda M, Goto N, Kimura G. Hypothesis on renal mechanism of non-dipper pattern of circadian blood pressure rhythm. Med Hypotheses. 2006;67:802–6.CrossRefPubMed
33.
go back to reference Hakoda M. Epidemiology of hyperuricemia and gout in Japan. Nippon Rinsho. 2008;66:647–52 (in Japanese).PubMed Hakoda M. Epidemiology of hyperuricemia and gout in Japan. Nippon Rinsho. 2008;66:647–52 (in Japanese).PubMed
34.
35.
go back to reference Okamoto M, Suzuki T, Fujiki M, Nobori S, Ushigome H, Sakamoto S, et al. The consequences for live kidney donors with preexisting glucose intolerance without diabetic complication: analysis at a single Japanese center. Transplantation. 2010;89:1391–5.CrossRefPubMed Okamoto M, Suzuki T, Fujiki M, Nobori S, Ushigome H, Sakamoto S, et al. The consequences for live kidney donors with preexisting glucose intolerance without diabetic complication: analysis at a single Japanese center. Transplantation. 2010;89:1391–5.CrossRefPubMed
36.
go back to reference Muntner P, He J, Astor BC, Folsom AR, Coresh J. Traditional and nontraditional risk factors predict coronary heart disease in chronic kidney disease: results from the atherosclerosis risk in communities study. J Am Soc Nephrol. 2005;16:529–38.CrossRefPubMed Muntner P, He J, Astor BC, Folsom AR, Coresh J. Traditional and nontraditional risk factors predict coronary heart disease in chronic kidney disease: results from the atherosclerosis risk in communities study. J Am Soc Nephrol. 2005;16:529–38.CrossRefPubMed
37.
go back to reference Schaeffner ES, Kurth T, Curhan GC, Glynn RJ, Rexrode KM, Baigent C, et al. Cholesterol and the risk of renal dysfunction in apparently healthy men. J Am Soc Nephrol. 2003;14:2084–91.PubMed Schaeffner ES, Kurth T, Curhan GC, Glynn RJ, Rexrode KM, Baigent C, et al. Cholesterol and the risk of renal dysfunction in apparently healthy men. J Am Soc Nephrol. 2003;14:2084–91.PubMed
38.
go back to reference Appel GB, Radhakrishnan J, Avram MM, DeFronzo RA, Escobar-Jimenez F, Campos MM, BMRENAAL Study, et al. Analysis of metabolic parameters as predictors of risk in the RENAAL study. Diabetes Care. 2003;26:1402–7.CrossRefPubMed Appel GB, Radhakrishnan J, Avram MM, DeFronzo RA, Escobar-Jimenez F, Campos MM, BMRENAAL Study, et al. Analysis of metabolic parameters as predictors of risk in the RENAAL study. Diabetes Care. 2003;26:1402–7.CrossRefPubMed
39.
go back to reference Delmonico F, Council of the Transplantation Society. A report of the Amsterdam forum on the care of the live kidney donor: data and medical guidelines. Transplantation. 2005;79:S53–66.CrossRef Delmonico F, Council of the Transplantation Society. A report of the Amsterdam forum on the care of the live kidney donor: data and medical guidelines. Transplantation. 2005;79:S53–66.CrossRef
40.
go back to reference Issa N, Stephany B, Fatica R, Nurko S, Krishnamurthi V, Goldfarb DA, et al. Donor factors influencing graft outcomes in live donor kidney transplantation. Transplantation. 2007;83:593–9.CrossRefPubMed Issa N, Stephany B, Fatica R, Nurko S, Krishnamurthi V, Goldfarb DA, et al. Donor factors influencing graft outcomes in live donor kidney transplantation. Transplantation. 2007;83:593–9.CrossRefPubMed
41.
go back to reference Health and Welfare Statistics Association. J Health Welf Stat. 2009;56:84. Health and Welfare Statistics Association. J Health Welf Stat. 2009;56:84.
42.
go back to reference Praga M, Hernandez E, Herrero JC, Morales E, Revilla Y, Diaz-Gonzalez R, et al. Influence of obesity on the appearance of proteinuria and renal insufficiency after unilateral nephrectomy. Kidney Int. 2000;58:2111–8.CrossRefPubMed Praga M, Hernandez E, Herrero JC, Morales E, Revilla Y, Diaz-Gonzalez R, et al. Influence of obesity on the appearance of proteinuria and renal insufficiency after unilateral nephrectomy. Kidney Int. 2000;58:2111–8.CrossRefPubMed
Metadata
Title
Kidney function, albuminuria and cardiovascular risk factors in post-operative living kidney donors: a single-center, cross-sectional study
Authors
Masahiko Yazawa
Ryo Kido
Yugo Shibagaki
Takashi Yasuda
Ryuto Nakazawa
Hideo Sasaki
Yuichi Sato
Tatsuya Chikaraishi
Kenjiro Kimura
Publication date
01-08-2011
Publisher
Springer Japan
Published in
Clinical and Experimental Nephrology / Issue 4/2011
Print ISSN: 1342-1751
Electronic ISSN: 1437-7799
DOI
https://doi.org/10.1007/s10157-011-0441-1

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