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Kidney Week

Abstract: FR-PO248

Risk Factors for Postevaluation Symptomatic Kidney Stones in Donor Candidates: A 17-Year Follow-Up Study

Session Information

Category: Bone and Mineral Metabolism

  • 502 Bone and Mineral Metabolism: Clinical

Authors

  • Keddis, Mira T., Mayo Clinic, Scottsdale, Arizona, United States
  • Quillen, Jaxon, Mayo Clinic, Scottsdale, Arizona, United States
  • Zhang, Nan, Mayo Clinic, Scottsdale, Arizona, United States
  • Rule, Andrew D., Mayo Foundation for Medical Education and Research, Rochester, Minnesota, United States
Background

We aimed to identify characteristics of kidney donor candidates who develop symptomatic kidney stone events after donor evaluation and assess whether donor status influences the risk of developing a symptomatic stone event.

Methods

A survey was conducted in 2022-2023 among 412 adults with a self-reported history or CT imaging evidence of nephrolithiasis at the time of their kidney donor evaluation at Mayo Clinic between 2000 and 2011. The survey inquired about post-evaluation symptomatic kidney stone events (renal colic pain or gross hematuria), complications, and management. Analyses were performed to assess stone characteristics and risk factors between donor candidates who experienced a symptomatic stone event versus those who did not.

Results

Of the 147 respondents (36% response rate), 94 donated, and 53 did not, with 25 non-donors attributed to kidney stone disease. After a median follow-up of 17 years, 26 respondents (18%) experienced a symptomatic stone event, with 13% being donors and 26% non-donors. Characteristics of donor candidates who experienced a symptomatic stone event post-evaluation are shown in Table 1. Non-donation was a risk factor for a symptomatic stone event in the unadjusted model (OR=2.44, p=0.041). Multivariate analysis indicated younger age (OR=1.05, p=0.031) and the presence of ≥2 kidney stones on imaging (OR=3.09, p=0.02) were associated with symptomatic stone events, while donor status was not (OR=1.49, p=0.41).

Conclusion

Kidney donor candidates who experience symptomatic kidney stones after evaluation tend to be younger, have a higher stone burden on imaging, require more surgical and medical management for stone disease, and were less likely to donate. Our findings suggest that our current donor evaluation process is generally effective in excluding younger stone formers with signficant stone burden on imaging and that these are the key factors to consider in stone formers undergoing donor evaluation.