Use of Opioids and NSAIDs in Living Kidney Donors: Clinical Correlates and Early Outcomes

K. Lentine¹, L. Vest¹, Z. Zhang¹, F. Koraishy¹, M. Schnitzler¹, A. Garg², D. Axelrod³, B. Kasiske⁴, G. Hess⁵, A. Naik⁶, D. Segev⁷, M. Henderson⁷, A. Massie⁷, N. Lamm⁸

¹Saint Louis Univ, St. Louis, MO, ²Western Univ, London, ON, Canada, ³Univ of Iowa, Iowa City, IA, ⁴SRTR, Minneapolis, MN, ⁵Univ of Pennsylvania, Philadelphia, PA, ⁶Univ of Michigan, Ann Arbor, MI, ⁷Johns Hopkins, Baltimore, MD, ⁸Univ Alberta, Edmonton, AB, Canada

Meeting: 2019 American Transplant Congress

Abstract number: B262

Keywords: Donation, Pain, Proteinuria, Renal function

Session Information

Session Name: Poster Session B: Kidney Living Donor: Quality and Selection

Session Type: Poster Session

Date: Sunday, June 2, 2019

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

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

Location: Hall C & D

*Purpose: Data are limited regarding pain medication use in living kidney donors (LKD). Concerns relate to opioid use, and to non-steroidal anti-inflammatory (NSAID) use in LKD due to potential nephrotoxicity.

*Methods: We examined a novel database wherein national LKD registry identifiers were linked to records from a large US pharmaceutical claims warehouse (2007-2017 fills). We selected LKD with 1 yr of postdonation fill records. Associations of baseline demographic and clinical factors with opioid and NSAID use (adjusted odds ratio, 95% _LCLaHR 95% _UCL) were quantified by multivariate logistic regression.

*Results: Among 23,564 eligible LKD, opioid use declined over time postdonation: 36.6%, mos. >0-0.5; 14.7%, mos. 0.6-6; 12.6%, mos. 7-12 (Fig A). NSAID use was uncommon, but increased: 0.5%, mos. >0-0.5; 2.2%, mos. 0.6-6; 3.3%, mos. 7-12. With adjustment including predonation estimated glomerular filtration rate (eGFR), hypertension, donor-recipient relationship and nephrectomy type, opioid use in mos. 7-12 was significantly (P<0.05) associated with female sex (_1.131.24_1.35), black race (_1.031.17_1.32), obesity (_1.241.38_1.53), less than college education (_1.191.31_1.43), not working (_1.021.12_1.24), smoking (_1.331.45_1.58), and surgical complications (_1.111.29_1.49) (Fig B). NSAID use was more common in women, black and Hispanic LKD, obese LKD, and those with lower education, not working, and with surgical complications. Patterns were similar in earlier postdonation periods. Neither opioids nor NSAIDs were associated with eGFR change or proteinuria to 2 years.

*Conclusions: Opioid and NSAID use in LKD varies with demographic and clinical traits. Work is needed to define safety and optimal choice of pain medications in LKD.

To cite this abstract in AMA style:

Lentine K, Vest L, Zhang Z, Koraishy F, Schnitzler M, Garg A, Axelrod D, Kasiske B, Hess G, Naik A, Segev D, Henderson M, Massie A, Lamm N. Use of Opioids and NSAIDs in Living Kidney Donors: Clinical Correlates and Early Outcomes [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/use-of-opioids-and-nsaids-in-living-kidney-donors-clinical-correlates-and-early-outcomes/. Accessed May 12, 2025.

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