Abstract
Abstract
Background
Kidney transplantation is the optimal treatment for end-stage renal disease (ESRD), but the persistent donor shortage necessitates expanding the donor pool, including utilizing living donors with dysglycemia. However, their post-nephrectomy safety remains inadequately characterized.
Methods
This retrospective cohort study analyzed 771 living donors (699 normal, 53 impaired fasting glucose [IFG], 19 diabetes) undergoing nephrectomy (2017-2023). The primary outcome was acute eGFR slope. Multivariable linear regression identified independent risk factors. A targeted systematic review with meta-analysis was conducted to summarize existing evidence.
Results
Over a median 31-month follow-up, no donors developed ESRD. Diabetic donors had a higher incidence of eGFR
Conclusion
Pre-donation diabetes may increase post-nephrectomy renal risk, while IFG alone may be safe unless accompanied by reduced baseline eGFR. Notably, these hypothesis-generating findings are limited by the small sample size of the diabetic and IFG groups, and relatively short follow-up. Large multicenter cohorts with decades-long follow-up are still required.