Clinical Assessment of Lipid Profiles in Live Kidney Donors

[Clark]

Transplantation Proceedings
Volume 47, Issue 3, April 2015, Pages 584–587
10th Japan-Korea transplantation forum
Clinical Assessment of Lipid Profiles in Live Kidney Donors
Y.E. Yoona, K.H. Choib, K.H. Kimc, S.C. Yangb, W.K. Hana, ,
doi:10.1016/j.transproceed.2014.12.035

Highlights
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Abnormal preoperative lipid profiles of living kidney donors are predictive of post-nephrectomy renal function, with total cholesterol and low-density lipoprotein levels assuming greater importance
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Lipid profiles of donors were similar whether or not histologic abnormalities of corresponding allografts were detected
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Donors with total cholesterol or low-density lipoprotein elevations are at increased risk of developing chronic kidney disease after nephrectomy.
Abstract
Background
Abnormal serum lipid profiles are an issue in chronic kidney disease (CKD), but the clinical ramifications of dyslipidemia in live kidney donors are unclear. Thus, we explored the relationship between serum lipids and residual renal function in living donors post-nephrectomy.

Methods
Charts of living donors who underwent nephrectomy between January 2010 and March 2013 were reviewed, targeting those with 6-month follow-up examinations at minimum. Altogether, 282 donors were studied, examining total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) levels assayed before donation by standard techniques. Median follow-up time was 14 months. The relationship between postoperative renal function and allograft biopsy results was assessed. Recursive partitioning was applied to identify optimal cut-off points for each parameter.

Results
Median (interquartile range) serum TC, TG, LDL, and HDL levels were 183 (161–205) mg/dL, 86 (63–131) mg/dL, 108 (92–128) mg/dL, and 53 (44–62) mg/dL, respectively. The glomerular filtration rate at last follow-up was associated with TC (r = −0.187; P = .002) and LDL (r = −0.172; P = .005) levels, but showed no correlation with TG and HDL. Root nodes of TC and LDL determinations in recursive partitioning were 170.5 mg/dL and 80.5 mg/dL, respectively, serving as thresholds for further evaluation. On logistic regression analysis, the likelihood of CKD (glomerular filtration rate < 60 mL/min/1.73 m2) at last follow-up was greater in donors with elevated TC and LDL levels (odds ratio = 1.96 and 3.33; P = .021 and .029, respectively).

Conclusion
Kidney donors with serum TC and LDL elevations require close observation, given their demonstrable predisposition to CKD after donation.