Concern over high cholesterol.

[Nancy]

I'm donating next month.  My cholesterol is 285.  I'm not on cholesterol medication.  The transplant team didn't even mention that it was high.  Is this high enough to be of concern?  My blood pressure is excellent.

[sherri]

I have found that each transplant team is different. There are no set standards that everyone needs to follow. Testing is all a little different. The team doesn't consider that cholesterol doesn't seem to play a direct factor into kidney function so I think it is something that is overlooked. Having high cholesterol may be a risk factor for developing cardiovascular disease in the future. What is also important is the cholesterol breakdown. What are your HDL (the "good" cholesterol) and you LDL (the"bad" cholesterol) and your triglycerides. Also family history is important. Sometimes the total cholesterol  is high (greater than 200, but the ratio between the HDL and LDL is within reason so no medication is advised at that point. This is a good topic to discuss with your primary care doctor and or outside nephrologist to evaluate in an unbiased way, how donating a kidney would effect your overall cardiovascular health. There are many articles that have been posted on here ( I think Donna Luebke, a cardiovascular nurse and living donor posted them) about increased risk of cardiovascular disease post LKD. We do know that kidney donors are at a slighter risk of developing an slight increase in blood pressure and proteinuria. Ultimately at the end of the day, each potential donor has to decide what their own personal risk to their future health may be (and if we could predict the future...) versus the risk.

The independent donor advocate recommended by OPTN (see Clark's post about the new role outlined in the OPTN guidelines) should be there to help donors in an unbiased way during the testing process. Ask about your independent donor advocate (ILDA) at your center and see if they can address some of your concerns. Good luck in the process. you are right to be asking a lot of questions about how living donation could effect your health. This way you make an informed and educated decision either way.


Sherri

[Fr Pat]

Dear Nancy,
     As Sherri explained above, whether the "total cholesterol" number should cause concern might depend on the numbers of the different types of cholesterol, etc.  But please keep in mind that the doctors involved in the potential transplant may be looking mostly at just those factors involved in safely doing the transplant rather than at your whole life-time health picture. I think it would be wise to discuss your cholesterol numbers with your regular doctor and get a solid opinion about whether you should take medication regarding cholesterol. (Likewise, if improvement is needed, see what diet and exercise changes might help.)
     I had slightly too-high cholesterol levels both before and after donation, but a daily pill keeps the nubers good. It seems to be genetic in my case, as my diet/exercise have been good for some time now.
     All the testing involved in possibly becoming a donor can serve another good purpose: to help you bee more aware and more pro-active in taking care of your own health.
     Please let us know how things develop.
   best wishes,
      Fr. Pat

[dodger]

Nancy, have you been to your PCP about the donation and the test results?  That is an excellent first step in finding out the answers to your questions.

Are you healthy enough to donate, probably.  Should probably address your cholesterol levels, probably.  The sooner you take care of yourself, the better you will be 20-30 years from now.

Diet and exercise are your two best weapons to fight this.  Medication should be secondary after first trying the first two.