Change of Bone and Mineral Metabolism in Kidney Donors after Uninephrectomy; Prospective Observational Study

E. Ko,^1,2 H. Cho,^1,3 B. Choi,^1,2 C. Park,^1,2 Y. Kim,^1,2 C. Yang,^1,2 B. Chung.^1,2

¹Transplant Research Center, Seoul St.Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
²Division of Nephrology, Department of Internal Medicine, Seoul St.Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
³Department of Urology, Seoul St.Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.

Meeting: 2018 American Transplant Congress

Abstract number: B171

Keywords: Donation, Kidney transplantation

Session Information

Session Name: Poster Session B: Kidney Living Donor: Long Term Outcomes

Session Type: Poster Session

Date: Sunday, June 3, 2018

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Hall 4EF

ackground: The aim of this study is to investigate whether uninephrectomy for kidney donation cause change of bone and mineral metabolism and also investigate factors associated with it in prospective kidney donors after uninephrectomy

Material and Methods: Serum and urine creatinine, calcium, phosphorus, and serum intact parathyroid hormone (iPTH), 25(OH) vitamin D values were obtained pre-donation and postoperatively in 32 donors. Renal fraction excretion rate of phosphate (FEpi) was calculated with 24-hour urine collection. Pre- and post-donation GFR was measured by DTPA scan in all donors. We defined post-donation chronic kidney disease-mineral bone disorder (CKD-MBD) as higher serum iPTH level than median (59.7 pg/ml) of all donors at post-transplant, and investigate factors associated with the development of CKD-MBD

Results: After donor nephrectomy, MDRD eGFR declined (93.1 to 61.2 ml/min/1.73m²) and remnant kidney's GFR measured by DTPA scan increased (53.9 to 63.8 ml/min), significantly. (both p<0.001) Post-donation serum iPTH increment was marked (56.8 Vs 47.4 pg/ml, p=0.055), and 25(OH) vitamin D level also rose (27.0 to 30.2 ng/ml, p=0.364).After donation, serum Ca was changed from 9.19 to 9.26 (p=0.181), serum phosphate changed from 3.4 to 3.3 (p=0.434). Renal fraction excretion rate of phosphate (FEpi) was increased after donation. (14.4 to 21.4, p<0.01) Compared with no-CKD group, CKD group showed higher increment of GFR by DTPA scan (15.1 Vs 8.6 ml/min/1.73m², p=0.069), higher increase of serum P level (+0.12 Vs -0.19, p=0.044), and higher change in serum Ca X P (1.4 Vs -1.7, p=0.04) In logistic regression analysis, after adjusting sex, age, BMI, pre-donation eGFR, the predictors of development of CKD-MBD was pre-donation FEpi. (OR 0.811, 95% CI 0.658-0.998, p=0.048)

Conclusion: Donor nephrectomy caused a significant change in bone and mineral metabolism in prospective kidney donors and pre-donation FEpi couble be a good predictive marker for early expecting development of CKD-MBD.

CITATION INFORMATION: Ko E., Cho H., Choi B., Park C., Kim Y., Yang C., Chung B. Change of Bone and Mineral Metabolism in Kidney Donors after Uninephrectomy; Prospective Observational Study Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Ko E, Cho H, Choi B, Park C, Kim Y, Yang C, Chung B. Change of Bone and Mineral Metabolism in Kidney Donors after Uninephrectomy; Prospective Observational Study [abstract]. https://atcmeetingabstracts.com/abstract/change-of-bone-and-mineral-metabolism-in-kidney-donors-after-uninephrectomy-prospective-observational-study/. Accessed November 24, 2024.

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