# CKD Risk Prediction among Obese Living Kidney Donors

> **NIH NIH R01** · UNIVERSITY OF ALABAMA AT BIRMINGHAM · 2021 · $671,314

## Abstract

SUMMARY
Living kidney donors continue to be a critical source of organs facilitating timely transplantation and excellent
outcomes. Historically, living donors were healthy and free of baseline abnormalities. In response to the organ
shortage, transplant centers now commonly approve donors classified as obese (body mass index (BMI) ≥
30kg/m2), and currently, more than 25% of all living donors are considered obese at donation. Relaxation of
selection criteria to include obese living donors has occurred despite a paucity of safety data. Determining
candidacy for living donation among obese individuals remains challenging, as the appropriate BMI cutoff
above which donation is no longer safe is unknown. Most centers have implemented a “one size fits all”
approach to setting BMI limits (e.g. individuals with BMI > 35kg/m2 are excluded from donation) rather than a
personalized approach that accounts for individual baseline differences. In the general population, obese
individuals have a 3.57-fold higher risk for ESRD compared to individuals with normal weight (BMI 18.5-24.9
kg/m2). Donors are not drawn from the general population, but are very carefully screened, and the impact of
obesity might be different in these healthier individuals. In a recent multi-cohort study of individuals healthy
enough to be potential donors (healthy non-donors), the adjusted risk for ESRD associated with obesity was
only 1.16-fold higher but varied significantly based on other baseline comorbidities. The true risk among obese
living donors likely falls somewhere in between these estimates: obese living donors are otherwise healthy at
baseline but lose half their nephron mass. Our preliminary findings suggest that risk for post-donation ESRD is
significantly higher among obese compared with non-obese donors. However, it remains unclear if this risk is
modified by other baseline comorbidities or obesity-related characteristics (e.g. BMI trajectory, metabolic
syndrome), reflective of underlying differences between obese and non-obese persons, or directly attributable
to donation itself. We hypothesize that the impact of obesity on post-donation ESRD risk varies significantly by
obesity-related characteristics and other comorbidities, and an obese phenotype exists in whom living kidney
donation is safe. To better understand the relationship between obesity and risk for post-donation kidney
failure, we will leverage and build upon an existing NIH-funded retrospective cohort study of live donors to
assemble the largest cohort of obese living donors and will: (1) explore the association of baseline health
characteristics with risk for post-donation kidney failure among obese living kidney donors; (2) explore the
association of obesity-specific risk factors with risk for post-donation kidney failure; (3) develop a tool for kidney
failure risk among obese living donors; (4) estimate risk for post-donation kidney failure among obese living
donors directly attributable to donation. ...

## Key facts

- **NIH application ID:** 10075136
- **Project number:** 5R01DK113980-04
- **Recipient organization:** UNIVERSITY OF ALABAMA AT BIRMINGHAM
- **Principal Investigator:** JAYME ELIZABETH LOCKE
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $671,314
- **Award type:** 5
- **Project period:** 2017-12-01 → 2022-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10075136

## Citation

> US National Institutes of Health, RePORTER application 10075136, CKD Risk Prediction among Obese Living Kidney Donors (5R01DK113980-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10075136. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*