Department of Medicine, Houston Methodist Hospital, Houston, Texas, USA.
Department of Pathology and Genomic Medicine, Institute for Academic Medicine, Houston Methodist Research Institute, Houston, Texas, USA.
Clin Transplant. 2021 Feb;35(2):e14189. doi: 10.1111/ctr.14189. Epub 2020 Dec 25.
Roughly 25% of US transplant centers exclude donor candidates with kidney stones fearing future obstructive consequences and the possible association between stones and CKD. We compared the development of hypertension, proteinuria, and reduced eGFR in 227 kidney donors with kidney stones to 908 propensity score-matched donor controls without kidney stones using data from The Renal and Lung Donor Evaluation (RELIVE) Study which studied intermediate and long-term outcomes of 8922 donors who donated between 1963 and 2007. 200 donors had kidney stones prior to donation, 21 had post-donation stones, and 6 had pre- and post-donation stones. Donors with stones were older, more likely to be Caucasian, less likely to be related to the recipient and had a higher fasting glucose. After 16.5 ± 10.9 years (range 0-44 years) from donation to study close, no ESKD occurred in donors with stones. The multivariable risks of hypertension, proteinuria, and reduced GFR were similar in donors with and without kidney stones. We could not demonstrate an association between stones and adverse renal outcomes in kidney donors, and the occurrence of post-donation stones was distinctly rare. These data may provide a rationale for possibly a wider acceptance of donor candidates with low kidney stones burden.
大约 25%的美国移植中心排除有肾结石的供体候选人,担心未来的阻塞后果和结石与 CKD 之间的可能关联。我们比较了 227 名有肾结石的肾脏供体和 908 名无肾结石的匹配倾向评分对照者的高血压、蛋白尿和 eGFR 降低的发展情况,这些数据来自于肾脏和肺脏供体评估(RELIVE)研究,该研究研究了 1963 年至 2007 年间捐赠的 8922 名供体的中期和长期结果。200 名供体在捐赠前有肾结石,21 名供体在捐赠后有肾结石,6 名供体在捐赠前和捐赠后都有肾结石。有结石的供体年龄较大,更可能是白种人,与受者的关系不太可能,空腹血糖更高。从捐赠到研究结束的 16.5±10.9 年(0-44 年)后,有结石的供体中没有发生终末期肾病。有肾结石和无肾结石供体的高血压、蛋白尿和 GFR 降低的多变量风险相似。我们无法证明结石与肾脏供体的不良肾脏结局之间存在关联,而且捐赠后结石的发生明显罕见。这些数据可能为可能更广泛地接受低肾结石负担的供体候选人提供依据。