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.
Jadaon et al. (Fri,) studied this question.