Living donor kidney transplantation has been increasing in South Korea. Considering rapid changes in lifestyle and chronic diseases in South Korea over the years, time-trend exploration and comparison of metabolic risk in live donors and healthy controls may help to estimate the future risk of live donors. Living kidney donors in seven national university hospital of South Korea from 1982 to 2018 were enrolled. To compare living kidney donors with individuals having similar health status, individuals voluntarily receiving health check-up in two tertiary hospital from 1995 to 2016 were included. After excluding participants with estimated glomerular filtration rate (eGFR) <50mL/min/1.73m2, diabetes and cancer, living kidney donors and healthy populations were matched for age, sex, baseline eGFR and era using direct matching methods. Hyperuricemia was defined as uric acid greater than 7mg/dL for male, 6mg/dL for female. Underweight, overweight and obesity were defined as body mass index (BMI) <18.5, 25-29.9, and â„30kg/m2, respectively. The era of the transplant was classified into 4 groups as follows; 1995-2000, 2001-2006, 2007-2011 and 2012-2016. To compare trends of metabolic risk factors between living kidney donor and matched healthy control according to the era, logistic regression analysis were performed using interaction terms on the era and kidney donation. The number of matched living kidney donors and healthy controls were 2,101, respectively. Their mean age was 42.3±11.5 years and 47.2% were male. Over the 21 years, the proportion of hyperuricemia increased across the era in both living kidney donors (4.3% at 1995-2002, 12.1% at 2012-2016) and healthy controls (7.0% at 1995-2002, 17.9% at 2012-2016), respectively. When compared to the slope of the trend for hyperuricemia between matched healthy control groups and living kidney donors, there were no difference. In the matched healthy control group, the percentage of SBP â„140mmHg seemed to increased and the proportion of living kidney donors remained stable approximately 9%, but there was no significant difference in the trend according to the era between two groups. In the view of overweight/obesity, BMI â„25kg/m2 was increased recently in the matched healthy control group from 25.0% at 1995-2000 to 30.7% at 2012-2016, while no definite changes were observed in living kidney donors (32.6% at 1995-2000 to 34.6%). However, the statistical difference between the trends between donors and matched controls did not observed. There were no differences in the trends of metabolic risk including hyperuricemia, overweight/obesity, systolic blood pressure â„140mmHg of living kidney donors and matched healthy controls.