Kidney donors have fewer overall bone fractures compared with non-donors
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Key takeaways:
- The rate of all types of fractures among kidney donors was significantly lower than in controls.
- There were 443 observed vs. 499.8 expected fractures between donors and controls.
Living kidney donors had a lower overall risk for bone fractures following donation but experienced significantly more vertebral breaks vs. a control group, researchers found.
A team of investigators led by Hilal Maradit Kremers, MD, of the division of epidemiology and department of quantitative health sciences at Mayo Clinic in Rochester, Minnesota, conducted a survey to evaluate interventions such as vitamin D3 to help reduce vertebral fractures and patient morbidity 25 years after donation. The study compared overall and site-specific risk in living donors with matched general population controls.
“Living kidney donation is not without health risks,” they wrote. Living donors “may have an increased risk of fractures due to reductions in kidney mass, lower concentrations of serum 1,25-dihydroxyvitamin D and secondary increases in serum parathyroid hormone.”
The study, which ran between 2021 and 2023, included 2,132 living kidney donors and 2,014 patients in a control group from Mayo Clinic, Hennepin County Medical Center or the University of Minnesota Medical Center. Participants (aged at least 50 years old with at least 10 years passing since donation) completed a survey about their bone and fracture health. The main outcome measure focused on rates of overall and site-specific fractures between the groups. Researchers completed statistical analyses in August 2023.
Overall, 42 donors and 137 controls were excluded from analyses because of incomplete survey data. Of the remaining patients, while the total rate of fractures was notably lower among donors, there were significantly more vertebral fractures among the group, Kremers and colleagues reported. The rate of all types of fractures among the 2,090 kidney donors was significantly lower than among the 1,877 controls, with 443 observed vs. the control group. There were more vertebral fractures among donors than controls, with 51 observed vs. 36 expected vertebral fractures.
“Although the overall fracture rate among donors was low, reductions in kidney mass and prolonged hyperparathyroidism may predispose living kidney donors to trabecular bone loss and vertebral fractures,” Kremers and colleagues wrote. “Treatment of excess vertebral fractures with dietary supplements ... may reduce the numbers.”
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