Effect of Obesity on Long-Term Clinical Outcomes after Kidney Donation

描述（由申请人提供）：为了满足对活体肾脏供体日益增长的需求，潜在捐赠者的入选标准变得越来越少，允许以前不符合条件的患者捐赠肾脏。越来越多地利用的一个捐赠群体是超重患者。有大量证据表明，超重的人更容易患上肾脏疾病，这要么是体重的直接结果，要么是肥胖相关的合并症（如糖尿病和高血压）的结果。此外，即使是轻微的肾功能不全也会增加患心血管（CV）疾病的风险，这在这一人群中已经很常见了。尽管有这些发现，但对于肥胖和捐赠对肾脏捐赠者整体健康的个体和相互作用的影响知之甚少。我们的研究通过检查肥胖对长期肾功能的影响和心血管危险因素的发展，如高血压、血脂异常和代谢综合征，在加州大学旧金山分校（UCSF）捐赠肾脏的患者超过5年（1967-2002），解决了其中的一些问题。加州大学旧金山分校的数据库由2500多名捐赠者组成，其中1949人属于这一类。对照组（n=978）将包括在此期间通过初步医学筛查评估但因ABO血型或交叉配型不相容而未捐赠的所有UCSF潜在肾脏捐赠者。使用精确的基于互联网的搜索协议，我们已经能够识别超过85%的捐赠者和2个肾脏对照者的当前地址和电话号码，并开始招募参与我们的研究。我们相信，这项研究的结果对于制定更精确的肾供者选择和长期保健维护指南将是重要的。公共卫生相关性：相关性声明本提案研究了在加州大学旧金山分校捐赠肾脏的患者中，肥胖对长期肾功能、高血压发展和其他心血管疾病危险因素的影响。我们相信，这项研究的结果对于制定更准确的肾供者选择和长期保健维护指南将是重要的。

DESCRIPTION (provided by applicant): In order to meet the growing demand for living donor kidneys, the inclusion criteria for prospective donors have become less selective, allowing previously ineligible patients to donate kidneys. One donor group that has become increasingly more utilized is the overweight patient. There is substantial evidence that overweight individuals are more susceptible to the development of renal disease either as a direct result of their weight or as a consequence of their obesity-related co-morbidities such as diabetes and hypertension. In addition, it appears that even mild renal dysfunction can increase the risk of developing cardiovascular (CV) disease, which is already more common in this population. Despite these findings, very little is known about the individual and interactive effects of obesity and donation on the overall health of kidney donors. Our study addresses some of these questions by examining the effects of obesity on long-term renal function and development of cardiovascular risk factors such as hypertension, dyslipidemia, and metabolic syndrome in patients who donated a kidney at the University of California, San Francisco (UCSF) more than 5 years ago (1967-2002). The UCSF database consists of more than 2500 donors, 1949 of which fit into this category. The control group (n=978) will comprise of all potential kidney donors at UCSF during this period who passed an initial medical screening evaluation but did not donate because they were found to be ABO- or crossmatch incompatible. Using an accurate internet-based search protocol, we have been able to identify the current addresses and telephone numbers of more than 85% of the donors and 2 kidney controls, and have initiated recruitment for participation in our study. We believe that the results of the proposed study will be important in developing more precise guidelines for the selection and long-term health care maintenance of kidney donors. PUBLIC HEALTH RELEVANCE: Relevance Statement This proposal examines the impact of obesity on long-term renal function and development of hypertension and other risk factors for cardiovascular disease in patients who donated a kidney at the University of California, San Francisco. We believe that the results of the proposed study will be important in developing more accurate guidelines for the selection and long-term health care maintenance of kidney donors.