Ravinder Singh, Ph.D., Director of the Mayo Clinic Endocrine Laboratory, and Rajiv Kumar, M.D., Consultant in Nephrology and Hypertension at Mayo Clinic, conducted a study that was recently featured in the American Society of Nephrology's publication In The Loop. The study, "Abnormalities in biomarkers of mineral and bone metabolism in kidney donors," was originally published in Kidney International.
Previous studies have suggested that kidney donors may have abnormalities of mineral and bone metabolism typically seen in chronic kidney disease. This may have important implications for the skeletal health of living kidney donors and for the understanding of the pathogenesis of long-term mineral and bone disorders in chronic kidney disease.
In this prospective study, 182 of 203 kidney donors and 173 of 201 paired normal controls had markers of mineral and bone metabolism measured before and at 6 and 36 months after donation. Donors had significantly higher serum concentrations of intact parathyroid hormone and fibroblast growth factor-23 at 6 and 36 months, respectively, as compared to healthy controls, and significantly reduced tubular phosphate reabsorption and serum phosphate concentrations. Serum 1,25- dihydroxyvitamin D3 concentrations were significantly lower, while 25-hydroxyvitamin D concentrations were significantly higher in donors compared to controls. Moreover, significantly higher concentrations of the bone resorption markers, carboxyterminal cross-linking telopeptide of bone collagen and aminoterminal cross-linking telopeptide of bone collagen, and the bone formation markers, osteocalcin and procollagen type I N-terminal propeptide were observed in donors. Thus, kidney donation alters serum markers of bone metabolism that could reflect impaired bone health.
By Gina Chiri-Osmond