title: Long-Term Body Mass Index Trends After Living-Donor Nephrectomy.
abstract: OBJECTIVE
  As the demand for kidney transplant allografts has increased, many centers are expanding the upper limit of acceptable body mass index for kidney donors. However, obesity is a risk factor for developing renal disease. Our goal was to quantify body mass index trends in donor nephrectomy patients and to institute nutrition counseling to promote sustainable weight loss to reduce the risk of metabolic syndrome-derived renal dysfunction.
  
  
  METHODS
  Ninety patients who underwent donor nephrectomy between 2007 and 2012 consented to having height and weight data collected at multiple time points. After data collection, each patient underwent a standardized nutrition counseling session. One year later, body mass index was reassessed.
  
  
  RESULTS
  Preoperatively, 52% of the patients were overweight or obese. The percentage of overweight and obese patients remained stable for 2 years after surgery. However, at 3, 4, and 5 years after surgery, these rates increased to 59%, 69%, and 91%. Each patient was counseled about obesity-related comorbidities and provided information about lifestyle modification. One year later, 94% of previously overweight patients and 82% of previously obese patients had a decrease in mean body mass index from 27.2 ± 4.0 kg/m2 to 25.1 ± 3.6 kg/m2.
  
  
  CONCLUSIONS
  Living-donor nephrectomy patients are at risk of developing obesity, similar to the adult population. Nutrition counseling may be beneficial to help normalize body mass index in patients who have become overweight or obese to potentially prevent obesity-related comorbidities. All patients were evaluated by a nutrition specialist after surgery to review our donor nephrectomy nutrition brochure. Body mass index monitoring and primary care follow-up appear to be appropriate surveillance methods.
authors.affiliation: From the Urology Academic Practice, Cedars-Sinai Medical Center, Los Angeles, California, USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Dru
authors.forename: Gerhard J
authors.initials: GJ
authors.lastname: Fuchs
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003376:Counseling; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects*; D015596:Nutrition Assessment; D044623:Nutrition Therapy; D009752:Nutritional Status; D009765:Obesity / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D012307:Risk Factors; D040242:Risk Reduction Behavior; D013997:Time Factors; D016896:Treatment Outcome; D015430:Weight Gain; D015431:Weight Loss