Abstract

Background

A comprehensive evaluation of potential living kidney donors is crucial to ensure their short and long-term safety. We explored differences in kidney biochemical indicators, blood pressure measurements, and glucose control pre- and post-kidney donation between women with pre-diabetes and those with normal glucose levels.

Methods

We performed a prospective cohort study at West Bank and Gaza University hospitals between 2016 and 2022. Differences in sociodemographic and clinical factors that were collected from the participants’ medical records between women with pre-diabetes and without diabetes, pre- and post-donation, were assessed using the chi-square test for categorical variables and the Mann–Whitney U test for variables with skewed distribution. Trained nurses performed anthropometric measurements and drew fasting blood samples at various time points from one year before donation to five years after donation.

Results

Altogether, 114 female kidney donors (57 with pre-diabetes) aged 27–45 years (median = 35.7, IQR = 5.6) were included in the study. The post-donation median Body Mass Index (BMI) remained higher in women with pre-diabetes (35.02) than in those without diabetes (29.34) five years after donation, (P < 0.001). The 24 h protein, diastolic, and systolic blood pressure levels were significantly higher among women with pre-diabetes than among those without diabetes five years after donation, (P < 0.001). The median estimated glomerular filtration rate (eGFR) was significantly lower in pre-diabetic women (78.2 ml/min/1.73 m²) compared with the non-diabetic participants (87.9 ml/min/1.73 m²) five years after donation, (P < 0.001).

Conclusions

Pre-diabetic donors showed an increased risk of adverse outcomes, including hypertension, impaired oral glucose tolerance test, worsening kidney function, and proteinuria. Our findings underscore the importance of maintaining regular check-ups and follow-ups in particular in pre-diabetic kidney donors.

Graphical abstract