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Kidney Blood Flow May Explain Increased Long-Term Risks for Obese Kidney Donors

Living kidney donors who are overweight or obese have increased blood pressure within the remaining kidney—which could explain the increased long-term risk of kidney damage previously found in this group of donors // , reports a paper being presented at the American Society of Nephrology's 39th Annual Meeting and Scientific Exposition in San Diego.

"Our study demonstrated that filtration pressure in the kidney was higher in overweight donors after donation," comments Dr. Mieneke Rook of University Medical Center Groningen in the Netherlands. "Higher filtration pressure is potentially harmful in the long run and may lead to an increased risk of long-term renal damage in obese kidney donors. With this information we can better ensure donor safety, as higher filtration pressure can easily be treated."

Using sophisticated renal measurements, Dr. Rook and colleagues assessed kidney function in 200 living kidney donors a few months before and after donation. Changes in kidney function after donation were analyzed, focusing on the possible effects of the donors' body weight.

For overweight and obese donors, the filtration fraction— a measure of blood pressure within the kidneys—was significantly higher after kidney donation. Increases in filtration fraction occurred even in donors who were modestly overweight. "This reflected elevated blood pressure within the kidney, also called hyperfiltration," Dr. Rook explains. "Hyperfiltration means that the kidneys work harder, which can overburden them and eventually lead to renal damage."

Before and after donation, filtration fraction was higher for patients at higher levels of body mass index (BMI), a standard measure of body fatness. On adjustment for other factors, both higher BMI and older age were independent predictors of increased filtration fraction after living kidney donation.

Obesity and overweight are risk factors for kidney damage. "With the shortage of organs f
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