Long-term follow-up data of living kidney donors with pre-existing pre-diabetes

Objectives: Renal transplantation is the best option for patients suffering from end-stage renal disease. The global epidemic of end-stage renal disease has resulted in a widening gap between the supply and demand of kidney donors. Thus, allowing donors from expanded donor criteria, which included a group of donors with pre-diabetes. We did a retrospective study to compare the long-term post-operative kidney functions, development of diabetes and hypertension, and proteinuria, of living donors having pre-diabetes at the time of donation with those donors without any evidence of pre-diabetes or diabetes at our center in the past 10 years. Material and Methods: Retrospective data were collected for living donor kidney transplants between January 2014 and December 2024 at our center. Study population: We included all the Kidney donors with no comorbidities who underwent donor nephrectomy at our center. We did not consider pre-diabetes as a comorbidity, and donors diagnosed with pre-diabetes were included in our study. Donors with other co-existing comorbidities such as hypertension and hypothyroidism were excluded. Donors were divided into two groups based on the presence of pre-diabetes in them. Two hundred and fifty-four donors were included in our study and were divided into two groups. Group 1 included 36 donors who had pre-diabetes at the time of donation, and Group 2 included 218 donors those who had no comorbidities (no pre-diabetes also) at the time of donation. We measured serum creatinine, 24 h urinary creatinine clearance, urinary proteins, urinary albumin, blood pressure, and the development of diabetes mellitus. Results: There was no significant difference observed for the change in serum creatinine or 24-h urinary creatinine clearance between Group 1, having pre-diabetes at the time of donation, and Group 2, which did not have pre-diabetes or any other comorbidity at the time of donation. Nor was there any significant difference in blood pressure in Group 1 and Group 2. There was a significant difference in the development of significant proteinuria and albuminuria between the two groups. Furthermore, the development of drug or insulin-dependent diabetes was significantly higher in Group 1. Conclusion: Pre-diabetic donors may be acceptable but require closer monitoring. As our study did not show evidence of deterioration in kidney function in them post donor nephrectomy.