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Bone Fractures Are Not Increased in Older Prior Living Kidney Donors

H. Amer1, H. Maradit Kremers1, D. Larson1, I. Zaniletti1, W. K. Kremers1, A. Matas2, B. Kasiske3, S. Khosla1, R. Kumar1

1Mayo Clinic, Rochester, MN, 2University of Minnesota, Minneapolis, MN, 3Hennepin County Medical Center, Minneapolis, MN

Meeting: 2022 American Transplant Congress

Abstract number: 799

Keywords: Elderly patients, Living donor, Morbidity, Osteoporosis

Topic: Clinical Science » Kidney » 39 - Kidney Living Donor: Long Term Outcomes

Session Information

Session Name: Kidney Living Donor: Long Term Outcomes

Session Type: Poster Abstract

Date: Saturday, June 4, 2022

Session Time: 5:30pm-7:00pm

 Presentation Time: 5:30pm-7:00pm

Location: Hynes Halls C & D

*Purpose: Living kidney donors were shown to have derangements of bone biomarkers resembling those occurring in early chronic kidney disease within 36 months of donation. The clinical significance of these findings is unknown. The objective of this study was to examine the risk of fractures in prior living kidney donors.

*Methods: We conducted a survey of previous kidney donors at three transplant centers who were more than 10 years post donation and were > 50 years of age. We compared the observed number of patients who self-reported fractures with expected numbers using standardized incidence ratios (SIR). Expected numbers were derived by applying local calendar year-, age- and sex-specific fracture rates to the calendar year-, age- and sex-specific person-years of follow-up in the kidney donor cohort.

*Results: Of the 930 surveys that were returned, 891 (95.8%) provided signed consent, and were included in the analysis. The mean age of the respondents was 65.0 (± 8.9, Range 48 – 93), 56% were female, mean time from donation was 20.2 years (± 8.9, Range 10.1 – 56.4). 145 (16.3%) donors reported at least one bone fracture and 36 (4.0%) reported more than one fracture. We observed a total of 145 respondents with fractures whereas the expected number of individuals with at least one fracture was 306.5 corresponding to a SIR of 0.47 (95% CI 0.4-0.56). Table 1 shows sex and site-specific fracture data.

*Conclusions: Older prior living kidney donors who responded to a survey have an overall lower risk of fractures compared to the general population. Comparison to a comparable healthy control population is necessary for validation of these findings.

Table 1 Sex and site-specific fracture data.
Site Observed Expected SIR 95% CI
Any Fracture Females 95 183.15 0.52 0.40-0.56
Any Fracture Males 50 123.38 0.41 0.42-0.63
Proximal Femur 3 11.01 0.27 0.30-0.53
Spine/Vertebral 17 43.16 0.39 0.06-0.80
Proximal Forearm 12 15.56 0.77 0.23-0.63
Distal Forearm 32 34.8 0.93 0.63-1.31
Hand 5 78.11 0.1 0.03-0.24

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To cite this abstract in AMA style:

Amer H, Kremers HMaradit, Larson D, Zaniletti I, Kremers WK, Matas A, Kasiske B, Khosla S, Kumar R. Bone Fractures Are Not Increased in Older Prior Living Kidney Donors [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/bone-fractures-are-not-increased-in-older-prior-living-kidney-donors/. Accessed May 30, 2025.

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