Cardiovascular Effects of Unilateral Nephrectomy in Living Kidney Donors

Moody, William E.; Ferro, Charles J.; Edwards, Nicola C.; Chue, Colin D.; Lin, Erica Lai Sze; Taylor, Robin J.; Cockwell, Paul; Steeds, Richard P.; Townend, Jonathan N.

doi:10.1161/hypertensionaha.115.06608

Cited by 87 publications

(118 citation statements)

References 49 publications

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“…We found 9 studies, 6–14 not including the current study 15, 16 reporting possible mineral and bone disorders in kidney donors (Table S1). Of the previous 9 studies, 5 were prospective, comparing changes before and after donation but did not include normal controls.…”

Section: Discussionmentioning

confidence: 98%

“…16 Despite reduced levels of serum phosphate, tubular resorption of phosphate declined (Table 3), indicating that renal phosphate excretion was the likely cause, or at least a contributing factor to the lower serum phosphate concentrations. Although 3 studies reported no change in serum phosphate concentrations, 6, 10, 14 3 others reported a decline in phosphate after kidney donation. 7, 11, 13 All studies that measured tubular resorption of phosphate reported a decline after donation.…”

Section: Discussionmentioning

confidence: 99%

“…11 Only 1 of the 9 studies was both prospective and controlled. 14 There is considerable heterogeneity in the results of these studies. Some differences may be attributable to study design, particularly with differences in sample size (most being small) and duration of follow-up (most being short).…”

Section: Discussionmentioning

confidence: 99%

“…5 Previous studies have reported that kidney donors have increased concentrations of serum parathyroid hormone (PTH) and fibroblast growth factor-23 (FGF23). 6–14 Studies report that donors have reduced serum concentrations of 1,25-dihydroxyvitamin D 3 (1,25(OH) 2 D 3 , calcitriol). 7–11, 13 Most studies, however, have been small, with short-term follow-up.…”

Section: Introductionmentioning

confidence: 99%

“…Only one study has been prospective and controlled, and only 1-year follow-up has been reported. 14 None of these studies has reported a comprehensive assessment of mineral metabolism.…”

Section: Introductionmentioning

confidence: 99%

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Abnormalities in biomarkers of mineral and bone metabolism in kidney donors

Kasiske

Kumar

Kimmel

et al. 2016

Kidney International

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Previous studies have suggested that kidney donors may have abnormalities of mineral and bone metabolism typically seen in chronic kidney disease. This may have important implications for the skeletal health of living kidney donors and for our understanding of the pathogenesis of long term mineral and bone disorders in chronic kidney disease. In this prospective study, 182 of 203 kidney donors and 173 of 201 paired normal controls had markers of mineral and bone metabolism measured before and at 6 and 36 months after donation (ALTOLD Study). Donors had significantly higher serum concentrations of intact parathyroid hormone (24.6% and 19.5%) and fibroblast growth factor-23 (9.5% and 8.4%) at 6 and 36 months, respectively, as compared to healthy controls, and significantly reduced tubular phosphate reabsorption (−7.0% and −5.0%) and serum phosphate concentrations (−6.4% and −2.3%). Serum 1,25-dihydroxyvitamin D3 concentrations were significantly lower (−17.1% and −12.6%), while 25-hydroxyvitamin D (21.4% and 19.4%,) concentrations were significantly higher in donors compared to controls. Moreover, significantly higher concentrations of the bone resorption markers, carboxyterminal cross-linking telopeptide of bone collagen (30.1% and 13.8%) and aminoterminal cross-linking telopeptide of bone collagen (14.2% and 13.0%), and the bone formation markers, osteocalcin (26.3% and 2.7%), and procollagen type I N-terminal propetide (24.3% and 8.9%) were observed in donors. Thus, kidney donation alters serum markers of bone metabolism that could reflect impaired bone health. Additional long term studies that include assessment of skeletal architecture and integrity are warranted in kidney donors.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Only one study has been prospective and controlled, and only 1-year follow-up has been reported. 14 None of these studies has reported a comprehensive assessment of mineral metabolism.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Abnormalities in biomarkers of mineral and bone metabolism in kidney donors

Kasiske

Kumar

Kimmel

et al. 2016

Kidney International

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Kidney structural characteristics based on a kidney biopsy and contrast‐enhanced computed tomography in healthy living kidney donors

Nielsen

Skov

Buus

et al. 2020

The Anatomical Record

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The demands for kidney transplantations are increasing, and so is the number of live kidney donors (LKDs). Recent studies show that LKDs have an increased risk of developing end‐stage renal disease compared with healthy non‐donors. However, the knowledge about factors predicting renal disease in kidney donors is sparse. Some evidence points to increased glomerular sclerosis and kidney fibrosis, as well as a low number of glomeruli as associated with a worse renal outcome. This methodological study investigated that which estimates are obtainable with a standard kidney biopsy taken from the donated kidney during the transplantation, and a standard contrast‐enhanced computed tomography (CT) in kidney donors. CT‐scans were used to obtain total volume of the kidney and kidney cortex using the Cavalieri estimator and 2D‐nucleator. Glomerular number density in the biopsies was estimated by a model‐based method, and was multiplied by total cortex volume in order to estimate the total number of glomeruli in the kidney. Glomerular volume was estimated by the 2D‐nucleator and a model‐based stereological technique. Kidney fibrosis (point‐counting), glomerular sclerosis (evaluation of glomerular profiles), and arteriole dimensions (2D‐nucleator) were also estimated in the biopsy sections from the donated kidney. Various studies have attempted to identify predictors of renal outcome in LKDs. There is no consensus yet, and further studies are needed to elucidate if and how the estimates described in this study are associated with renal outcome in LKDs.

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