Living kidney donation does not adversely affect serum calcification propensity and markers of vascular stiffness

Transpl Int. 2015 Sep;28(9):1074-80. doi: 10.1111/tri.12595. Epub 2015 May 18.

Abstract

Living kidney donors (LKDs) experience a decline in glomerular filtration rate (GFR) after donation. Calcification propensity (T50 ) can be determined by a blood test predicting all-cause mortality in patients with chronic kidney disease. We studied the impact of kidney donation on T50 and markers of arterial stiffness. We analyzed T50 prospectively before and 1 year after kidney donation in 21 LKDs along with fetuin-A, mineral metabolism markers, kidney length, pulse wave velocity (PWV), augmentation index (AI), and renal resistive index (RRI) as markers of arterial stiffness. We studied the impact of kidney donation on these parameters. LKDs were 54 ± 10 years old and had a GFR of 101 ± 18 ml/min/1.73 m(2) before donation, decreasing to 67 ± 8 ml/min/1.73 m(2) after donation (P < 0.001). Despite this, T50 improved after donation (290 ± 53 to 312 ± 38 min, P = 0.049). This change was inversely related to plasma phosphate (P = 0.03), which declined after donation (P = 0.002). Fetuin-A levels increased after donation (P = 0.01). Upon donation, the length of the remaining kidney increased (P < 0.001) while PWV, AI, and RRI remained unchanged. Calcification propensity was not adversely affected by kidney donation. This indicates that T50 is independent from GFR in LKDs and that kidney donation does neither worsen calcification propensity nor markers of vascular stiffness at 1 year.

Keywords: arterial stiffness; calcification; fetuin-A; living kidney donors; phosphate.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Arteries / pathology
  • Calcinosis / blood*
  • Disease Progression
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Kidney / metabolism
  • Kidney / pathology
  • Kidney Failure, Chronic / blood
  • Kidney Failure, Chronic / mortality
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation / methods*
  • Living Donors*
  • Male
  • Middle Aged
  • Nephrectomy
  • Phosphates / chemistry
  • Prospective Studies
  • Pulse Wave Analysis
  • Tissue and Organ Harvesting
  • Vascular Stiffness*
  • alpha-2-HS-Glycoprotein / metabolism

Substances

  • Phosphates
  • alpha-2-HS-Glycoprotein