肥満を伴う生体腎移植ドナーの短期腎予後

摘要

【Objective】 Obesity may cause obesity-related nephropathy due to glomerular hyperfiltration and the like. There is concern that the risk of kidney injury may increase due to progression of glomerular hyperfiltration after nephrectomy of living kidney donors with obesity. We conducted a retrospective observational study on short-term renal prognosis of living kidney donors with obesity. 【Methods】 Between April 2003 and July 2013, 149 living kidney donors who were followed 3 years or more were treated as BMI2 (normal group), 25.0 kg/m 2 ≤BMI2 (obese group), or 30.0 kg/m 2 ≤BMI (maximum 33.1 kg/m 2 ) (highly obese group), and eGFR and proteinuria were compared. 【Results】 Among the 149 donors, 100 normal subjects, 43 obese subjects and 6 highly obese subjects were included. There was no significant difference in the preoperative renal function or the observation period among the 3 groups. The eGFR after 1 year was 54.3±10.8 ml/min/1,73 m 2 , 51.3±10.3 ml/min/1,73 m 2 , and 57.3±12.2 ml/min/1,73 m 2 ( p =0.213), and the eGFR at the final examination was 55.0±11.8 ml/min/1,73 m 2 , 54.4±13.5 ml/min/1,73 m 2 , and 54.7±14.0 ml/min/1,73 m 2 ( p =0.978), and the protein urine appearance rates were 14.0, 25.6 and 16.7 ( p =0.223), respectively, and there was no significant difference. 【Conclusion】 In this study, obese living kidney donors were not significantly different from non-obese living kidney donors in short-term renal prognosis. Further long-term observation and examination of more cases are necessary.