Document Type
Original Research
Disciplines
Higher Education | Medicine and Health Sciences | Nephrology
Abstract
Background. Living kidney donor transplantation provides recipients with kidney failure with an excellent graft function and survival. Donation of a kidney entails a thorough medical and psychosocial evaluation. Obesity is an increasingly prevalent medical condition and a known risk factor for the development of chronic kidney disease post-donation. Accepting overweight and obese individuals as living kidney donors remains controversial. The purpose of this study was to review the impact of obesity on the determination of candidates for living kidney donation at a single transplant center.
Methods. We performed a retrospective chart review of living kidney donors evaluated over 5 years from January 1, 2019, to June 23, 2024 (n = 375). Data collected included donor demographics, lab testing, and health data, including body mass index (BMI), and weight loss interventions for those identified with a BMI ≥ 32 or a BMI ≥ 30-31.9 with medical comorbidities. Data analysis included descriptive statistics comparing approved versus declined donor candidates and interventions for weight loss if required.
Results. A total of 375 individuals were invited for in-person evaluation for donation, of which 155 (41.3%) were declined. Key reasons for declination included medical co-morbidities (n = 73; 47%), psychosocial factors (n = 14; 9.2%), and elevated BMI (n = 22; 14%) as either primary or secondary reasons. Of the 22 obese individuals evaluated, nearly all had a consultation with our dietitian, with additional interventions recommended. Of those approved for donation, 13.2% required additional weight loss, with 100% (n = 29) receiving nutrition consults and some requiring weight loss medications.
Conclusion. Candidacy for living kidney donation is in part dependent on BMI, along with other co-existing factors. Weight loss interventions included primarily a dietitian consultation, as well as diet and exercise, with infrequent use of GLP-1 agonists likely related to the timeframe of the study. These results should inform protocolized management of living donor candidates with obesity.
DOI
10.32873/unmc.dc.gmerj.8.1.006
Keywords
living kidney donation, obesity, weight loss
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Recommended Citation
Dumitrescu, J., Mannon, R., Westphal, S., Brabec, A., Rau, R., Olsen, A., , Cidlik, T. Facilitating Living Kidney Donation: Retrospective Evaluation of Weight Loss Interventions to Support Kidney Donation. Graduate Medical Education Research Journal. 2026 Jun 30; 8(1).
https://digitalcommons.unmc.edu/gmerj/vol8/iss1/6
