After organ donation, kidney stone formers saw fewer cases of nephrolithiasis
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Key takeaways:
- Individuals who were kidney stone formers and donated a kidney had fewer stone-related events after donation compared to those who were turned down for donation.
- The study involved 161 donor candidates.
PHILADELPHIA — The incidence for a kidney stone event was lower in a cohort of individuals 1 year after donating a kidney compared to individuals who were turned down for donation, data from ASN Kidney Week showed.
Researchers conducted a prospective observational study to better understand “who comes in for a kidney-donor evaluation with kidney stones, and among those patients, what the variables are that determine which get rejected vs. those that get accepted” for donation, Mira T. Keddis, MD, a consultant and associate professor of medicine in the division of nephrology and hypertension at the Mayo Clinic Scottsdale, told Healio.
“We wanted to understand whether we can identify predictors or variables that can guide us as providers in terms of who's at risk for a symptomatic kidney stone event after donation,” Keddis, co-director of the Stone Clinic at Mayo since 2014, said.
Keddis and colleagues sent a survey to 446 adults with self-reported history or CT imaging evidence of nephrolithiasis at the time of kidney donor evaluation from 2000 to 2016 at the Mayo Clinic.
The survey was completed by 161 of the donor candidates, 113 of whom were approved and 48 were denied for a kidney donation. Of that group, 26 (16%) experienced a symptomatic stone event after donor evaluation “and this occurred more frequently in denied vs. approved donors (27% vs. 12%, P = 0.019), in the first 4 years after evaluation (19% vs 1%, P < 0.001),” the researchers wrote.
Analyses assessed differences in stone burden between approved and denied donors and risk factors associated with symptomatic stone events. Factors associated with denial for donation included presence of medullary sponge kidney, two stones or more on CT imaging, presence of bilateral kidney stones and diameter of the largest stone of 3 mm or more.
“There was no difference in medical management, surgical/procedural management or reported development of chronic kidney disease between the two groups,” Keddis and colleagues wrote. “Risk factors for symptomatic stone events after evaluation include bilateral kidney stones (P < 0.001), kidney stone diameter of 3 mm or greater (P = 0.019), younger age (P = 0.008), and two or more stones on CT imaging (P = 0.003).
“Our findings identified kidney stone characteristics associated with denial for donation and risk for symptomatic stone event after donor evaluation that may better inform donor candidates of the risk for symptomatic stone events. The lack of significant differences in management and complications between approved and rejected donor candidates questions current approaches to denial based on stone risk,” the researchers concluded.
Editor’s note: On Nov. 9, 2023, the headline of the story was updated to clarify that kidney stone formers who donated a kidney had fewer kidney stone events during a 1-year follow-up.
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Keddis MT, et al. TH-PO901. Presented at: American Society of Nephrology Kidney Week; Nov. 2-5, 2023; Philadelphia.
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