Kidney Week

Abstract: TH-PO901

Risk of Symptomatic Kidney Stones After Kidney Donor Evaluation in Stone Formers

Session Information

• Transplantation: Donation and Access
  November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2102 Transplantation: Clinical

Authors

• Keddis, Mira T., Mayo Clinic, Scottsdale, Arizona, United States

Mira T. Keddis,

• Zhang, Nan, Mayo Clinic, Scottsdale, Arizona, United States

Nan Zhang,

• Quillen, Jaxon, Mayo Clinic, Scottsdale, Arizona, United States

Jaxon Quillen,

• D'Costa, Matthew R., Mayo Foundation for Medical Education and Research, Rochester, Minnesota, United States

Matthew R. D'Costa,

• Khamash, Hasan, Mayo Clinic, Scottsdale, Arizona, United States

Hasan Khamash,

• Jadlowiec, Caroline, Mayo Clinic, Scottsdale, Arizona, United States

Caroline Jadlowiec,

• Wadei, Hani, Mayo Clinic, Jacksonville, Florida, United States

Hani Wadei,

• Porter, Ivan E., Mayo Clinic, Jacksonville, Florida, United States

Ivan E. Porter,

• Rule, Andrew D., Mayo Foundation for Medical Education and Research, Rochester, Minnesota, United States

Andrew D. Rule,

Background

There are limited data on outcomes of kidney donor candidates with nephrolithiasis. We sought to identify risk factors for symptomatic kidney stone events after donor evaluation.

Methods

A survey was sent in 2022 to 446 adults with self-reported history or CT imaging evidence of nephrolithiasis at the time of kidney donor evaluation at Mayo Clinic (3 sites) between 2000 and 2016. The survey queried post-evaluation symptomatic (renal colic or gross hematuria) kidney stone events, complications, and management. Analyses assessed differences in stone burden between approved and denied donors and risk factors associated with symptomatic stone events.

Results

Survey was completed by 161 (36%) of 446 kidney donor candidates with kidney stones, of whom 113 were approved and 48 were denied for donation. 26 (16%) experienced a symptomatic stone event after donor evaluation and this occurred more frequently in denied vs approved donors (27% vs 12%, p=0.019), in the first 4 years after evaluation (19% vs 1%, p<0.001). Factors associated with denial for donation included presence of medullary sponge kidney, ≥2 stones on CT imaging, presence of bilateral kidney stones, and diameter of largest stone ≥3mm. [Table 1] There was no difference in medical management, surgical/procedural management, or reported development of chronic kidney disease between the two groups. Risk factors for symptomatic stone events after evaluation include bilateral kidney stones (p<0.001), kidney stone diameter≥3mm (p=0.019), younger age (p=0.008), and ≥2 stones on CT imaging (p=0.003).

Conclusion

Our findings identified kidney stone characteristics associated with denial for donation and risk for symptomatic stone event after donor evaluation that may better inform donor candidates of the risk for symptomatic stone events. The lack of significant differences in management and complications between approved and rejected donor candidates questions current approaches to denial based on stone risk.