Bone and Mineral Metabolism and Fibroblast Growth Factor 23 Levels After Kidney Donation

Young, Ann; Hodsman, Anthony B.; Boudville, Neil; Geddes, Colin; Gill, John S.; Goltzman, David; Jassal, Sarbjit V.; Klarenbach, Scott; Knoll, Greg; Muirhead, Norman; Prasad, G. V. Ramesh; Treleaven, Darin; Garg, Amit X.

doi:10.1053/j.ajkd.2011.09.019

Cited by 52 publications

(54 citation statements)

References 33 publications

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“…52,53 In comparison with healthy nondonors, living kidney donors have higher levels of plasma parathyroid hormone, higher fractional urinary excretion of phosphate, lower serum phosphate, lower serum calcitriol levels, and similar serum calcium levels. 54,55 These biochemical changes are similar to those observed in patients with CKD-related bone and mineral disorders.…”

Section: Fracturessupporting

confidence: 75%

Long-term medical risks to the living kidney donor

et al. 2015

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Living kidney donation benefits recipients and society but carries short-term and long-term risks for the donor. This Review summarizes the studies that underlie our current understanding of these risks in the first decade after donation, with a view to improving the informed consent process. Two studies report a higher risk of end-stage renal disease (ESRD) among donors than among healthy nondonors; however, the absolute 15-year incidence of ESRD is <1%. All-cause mortality and the risk of cardiovascular events are similar among donors and healthy nondonors, although one study provides evidence for a 5% increase in all-cause mortality after 25 years that is attributable to donation. Some evidence suggests that the 20-year incidence of gout is slightly higher among donors than among healthy nondonors. The risks of gestational hypertension or pre-eclampsia seem to be 6% higher in pregnancies among donors than in pregnancies among healthy nondonors. The incidences of acute kidney injury, kidney stones that require surgical intervention, gastrointestinal bleeding and fractures seem no higher among donors than among healthy nondonors, although some of these conclusions are based on a small number of events. Future studies must clarify the lifetime incidence of long-term outcomes, particularly in relation to a donor's age, race, and history of comorbidities.

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Section: Fracturessupporting

confidence: 75%

Long-term medical risks to the living kidney donor

et al. 2015

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“…Estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation and represented as milliliters per minute per 1.73 m 2 of body surface area [20]. Renal fractional excretion of inorganic phosphate (FE Pi ) was calculated as previously described [21]. Serum 1,25(OH) 2 D 3 was measured using an I 125 radioimmunoassay kit (DiaSorin, MN, USA) according to the manufacturer's instructions.…”

Section: Laboratory Assaysmentioning

confidence: 99%

Increased serum fibroblast growth factor-23 and decreased bone turnover in patients with systemic lupus erythematosus under treatment with cyclosporine and steroid but not steroid only

et al. 2014

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“…Donor Nephrectomy Outcomes Research (DONOR) Network investigators, in a cross-sectional study of 198 previous donors, documented similar changes plus increased fibroblast growth factor 23 levels. 13 More recently, two large registry-based studies report previously undocumented incremental long-term risk of ESRD and, possibly, mortality in prior donors. Mjoen et al, 14 15 The same group, again using CMS data but with a median follow-up of 7.6 years (maximum of 15 years), compared risk of ESRD in 96,217 donors with matched NHANESIII controls and documented a similar magnitude (to the Norwegian study) of increased ESRD risk in donors: 30.8/ 10,000 (95% CI, 24.3 to 38.5) in previous donors versus 3.9/10,000 (95% CI, 0.8 to 8.9) in healthy controls.…”

mentioning

confidence: 99%

“…The works by Kasiske et al 12 and the DONOR Network investigators 13 document preservation of renal function without significant proteinuria in the overwhelming majority of previous donors. Additionally, regardless of hazard ratios or cohort characteristics, the incidence of ESRD and mortality among previous donors is very low over very lengthy periods of time.…”

mentioning

confidence: 99%

“…7 Second, these reports clearly advance and refine our understanding of medical risk in living donors. Certainly, maturing of the databases examined by Kasiske et al 12 and the DONOR Network 13 should result in additional insight into physiologic and potentially pathophysiologic consequences of donor nephrectomy. Third, payers and regulators alike must understand these data as a work in progress, requiring the same perspicuity in interpretation as we practitioners ought to practice; rash decisions on the basis of superficial reading of evolving data are never justified.…”

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Reassessing Medical Risk in Living Kidney Donors

Gaston

Kumar

Matas

2015

Journal of the American Society of Nephrology

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The short-and long-term effects of unilateral nephrectomy on living donors have been important considerations for 60 years. Short-term risk is well established (0.03% mortality and ,1% risk of major morbidity), but characterization of long-term risk is evolving. Relative to the general population, risk of mortality, ESRD, hypertension, proteinuria, and cardiovascular disease is comparable or lower. However, new studies comparing previous donors with equally healthy controls indicate increased risk of metabolic derangements (particularly involving calcium homeostasis), renal failure, and possibly, mortality. We discuss how these results should be interpreted and their influence on the practice of living donor kidney transplantation.

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Bone and Mineral Metabolism and Fibroblast Growth Factor 23 Levels After Kidney Donation

Cited by 52 publications

References 33 publications

Long-term medical risks to the living kidney donor

Long-term medical risks to the living kidney donor

Increased serum fibroblast growth factor-23 and decreased bone turnover in patients with systemic lupus erythematosus under treatment with cyclosporine and steroid but not steroid only

Reassessing Medical Risk in Living Kidney Donors

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