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Sarwal A, Yamauchi J, Raghavan D, Shihab F, Fornadi K, Rofaiel G, Zimmerman M, Campsen J, Baker N, Akhila Ganireddy Y, Aviles-Ovalle L, Baker T, Hall IE, Molnar MZ. Throwing stones: kidney stone incidence in living kidney donor candidates with increased metabolic risk. Ren Fail 2023; 45:2226763. [PMID: 37357461 PMCID: PMC10294741 DOI: 10.1080/0886022x.2023.2226763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 06/13/2023] [Indexed: 06/27/2023] Open
Affiliation(s)
- Amara Sarwal
- Department of Internal Medicine, Division of Nephrology & Hypertension, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA
| | - Junji Yamauchi
- Department of Internal Medicine, Division of Nephrology & Hypertension, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA
| | - Divya Raghavan
- Department of Internal Medicine, Division of Nephrology & Hypertension, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA
| | - Fuad Shihab
- Department of Internal Medicine, Division of Nephrology & Hypertension, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA
| | - Katalin Fornadi
- Department of Surgery, Division of Transplantation and Advanced Hepatobiliary Surgery, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA
| | - George Rofaiel
- Department of Surgery, Division of Transplantation and Advanced Hepatobiliary Surgery, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA
| | - Michael Zimmerman
- Department of Surgery, Division of Transplantation and Advanced Hepatobiliary Surgery, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA
| | - Jeffrey Campsen
- Department of Surgery, Division of Transplantation and Advanced Hepatobiliary Surgery, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA
| | - Nicholas Baker
- Department of Surgery, Division of Transplantation and Advanced Hepatobiliary Surgery, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA
| | - Yamini Akhila Ganireddy
- Department of Surgery, Division of Transplantation and Advanced Hepatobiliary Surgery, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA
| | - Leonardo Aviles-Ovalle
- Department of Surgery, Division of Transplantation and Advanced Hepatobiliary Surgery, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA
| | - Talia Baker
- Department of Surgery, Division of Transplantation and Advanced Hepatobiliary Surgery, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA
| | - Isaac E. Hall
- Department of Internal Medicine, Division of Nephrology & Hypertension, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA
| | - Miklos Z. Molnar
- Department of Internal Medicine, Division of Nephrology & Hypertension, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA
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Bin Mohamed Ebrahim ME, Singla A, Yao J, Laurence JM, Wong G, Lau H, Lee T, Yuen L, Lim WH, Pleass H. Outcomes of live renal donors with a history of nephrolithiasis; A systematic review. Transplant Rev (Orlando) 2023; 37:100746. [PMID: 36587468 DOI: 10.1016/j.trre.2022.100746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
The clinical outcomes of kidney donors with a prior history of nephrolithiasis are poorly defined. We conducted a systematic review assessing the post-donation clinical outcomes of kidney donors with a history of nephrolithiasis. Electronic databases (Ovid and Embase) were searched between 1960 and 2021 using key terms and Medical Subject Headings (MeSH) - nephrolithiasis, renal stones, renal transplantation and renal graft. Articles included conference proceedings and journal articles and were not excluded based on patient numbers. Primary outcome was donor stone-related event. Secondary outcomes were renal function upon follow-up or post-operative nephrectomy complications. In summary, 340 articles were identified through database search. We identified 14 studies (16 cohorts) comprising 432 live donors followed up for a median of 26 months post live kidney donation. Six donors donated the stone-free kidney whilst 23 live donors had bilateral stones. Mean stone size was 4.2 ± 1.4 mm (1-16) with average follow up duration of 21.1 months (1-149). Twelve studies provided primary outcome (n = 138 patients) and eight (n = 348) for secondary outcomes. One donor had a stone-related event upon follow up. A total of 195 patients had eGFR <60 upon follow up. However, they were not significantly different when compared to renal function of live donors that didn't have pre-donation nephrolithiasis. Many of the studies couldn't provide long term follow up, coupled with limited data regarding the nature of the pre-donation stone disease. In conclusion, this systematic review shows that we have very limited information upon which to base recommendation regarding pre-donation risk of post-donation complications. Longer term follow up is required and lifelong follow up with live donor registries will aid further understanding.
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Affiliation(s)
- Mohamed Eftal Bin Mohamed Ebrahim
- Department of Surgery, Royal North Shore Hospital, Sydney, NSW 2065, Australia; Specialty of Surgery, FMH, University of Sydney, Sydney, NSW 2000, Australia; Department of Surgery, Westmead Hospital, Sydney, NSW 2145, Australia.
| | - Animesh Singla
- Specialty of Surgery, FMH, University of Sydney, Sydney, NSW 2000, Australia; Department of Vascular Surgery, Royal North Shore Hospital, NSW 2065, Australia
| | - Jinna Yao
- Specialty of Surgery, FMH, University of Sydney, Sydney, NSW 2000, Australia; National Pancreas Transplant Unit, Westmead Hospital, Sydney, NSW 2145, Australia; Department of Urology, Westmead Hospital, Sydney, NSW 2145, Australia
| | | | - Germaine Wong
- Renal Transplant Unit, Westmead Hospital, Sydney, NSW 2145, Australia; University of Sydney, Sydney, NSW 2000, Australia
| | - Howard Lau
- Department of Surgery, Westmead Hospital, Sydney, NSW 2145, Australia; Western Sydney University, Sydney, NSW 2000, Australia
| | - Taina Lee
- Specialty of Surgery, FMH, University of Sydney, Sydney, NSW 2000, Australia; Department of Surgery, Westmead Hospital, Sydney, NSW 2145, Australia
| | - Lawrence Yuen
- Specialty of Surgery, FMH, University of Sydney, Sydney, NSW 2000, Australia; Department of Surgery, Westmead Hospital, Sydney, NSW 2145, Australia
| | - Wai H Lim
- Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, WA 6009, Australia; School of Medicine, University of Western Australia, Perth, WA 6009, Australia
| | - Henry Pleass
- Specialty of Surgery, FMH, University of Sydney, Sydney, NSW 2000, Australia; Department of Surgery, Westmead Hospital, Sydney, NSW 2145, Australia
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Clinical and Kidney Structural Characteristics of Living Kidney Donors With Nephrolithiasis and Their Long-term Outcomes. Transplant Direct 2021; 8:e1278. [PMID: 34966845 PMCID: PMC8710319 DOI: 10.1097/txd.0000000000001278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/09/2021] [Accepted: 11/16/2021] [Indexed: 11/26/2022] Open
Abstract
Nephrolithiasis in living kidney donors is concerning due to the potential impact on long-term postdonation kidney function.
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Arabi Z, Hamad A, Bukhari M, Altheaby A, Kaysi S. Practice Patterns for the Acceptance of Medically Complex Living Kidney Donors with Hematuria, Sickle Cell Trait, Smoking, Illegal Drug Use, or Urological Issues: A Multinational Survey. Avicenna J Med 2021; 11:185-195. [PMID: 34881201 PMCID: PMC8648410 DOI: 10.1055/s-0041-1736542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Background To review the practice patterns for the acceptance of medically complex living kidney donors (MCLKD) among the transplant providers of the international transplant community. Methods We distributed a survey globally, through major international transplantation societies, among nephrologists and transplant surgeons (TS). The survey contained questions regarding potential donors with microscopic hematuria, sickle cell trait, renal cysts, kidney stones, smoking, or illegal drug use. Results There were 239 respondents from 29 countries, including nephrologists (42%) and TS (58%). Although most respondents would investigate microscopic hematuria, one-third of them indicated they would decline these potential donors without investigation. Interestingly, most respondents accepted heavy smokers, intermittent illegal drug users (with advice to quit), and those with incidentally identified kidney stones, remote history of renal colic or simple renal cysts. We found multiple areas of consensus in practice with some interesting differences between nephrologists and TS. Conclusions This survey highlights the practice patterns of the acceptance of MCLKDs among the international community. In the absence of clear guidelines, this survey provides additional information to counsel kidney donors with microscopic hematuria, sickle cell trait, renal cysts, kidney stones, heavy smoking, or illegal drug use.
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Affiliation(s)
- Ziad Arabi
- Department of the Organ Transplant Center, Division of Adult Transplant Nephrology, King Abdulaziz Medical City, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdullah Hamad
- Department of Medicine, Division of Nephrology, Regional Medical Center of Orangeburg and Calhoun Counties, Orangeburg, South Carolina, United Sates
| | - Muhammad Bukhari
- Department of Medicine, Division of Adult Nephrology, Taif University, Taif, Saudi Arabia
| | - Abdulrahman Altheaby
- Department of the Organ Transplant Center, Division of Adult Transplant Nephrology, King Abdulaziz Medical City, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Saleh Kaysi
- Department of Medicine, Division of Nephrology, CHU Clermont-Ferrand, France
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Bessede T, Branchereau J, Goujon A, Boissier R, Alezra E, Verhoest G, Culty T, Matillon X, Doerfler A, Tillou X, Sallusto F, Terrier N, Thuret R, Drouin S, Timsit MO. [Urinary stones in renal transplant recipients and donors: The French guidelines from CTAFU]. Prog Urol 2021; 31:57-62. [PMID: 33423749 DOI: 10.1016/j.purol.2020.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 03/27/2020] [Accepted: 03/30/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To define guidelines for the management of kidney stones in kidney transplant (KTx) donor or recipients. METHOD Following a systematic approach, a review of the literature (Medline) was conducted by the CTAFU to report kidney stone epidemiology, diagnosis and management in KTx donors and recipients with the corresponding level of evidence. RESULTS Prevalence of kidney stones in deceased donor is unknown but reaches 9.3% in living donors in industrialized countries. Except in Maastrich 2 donors, diagnosis is done on systematic pre-donation CT scan according to standard french procedure. No prospective study has compared therapeutic strategies available for the management of kidney stones in KTx donor: ureteroscopy or an extra corporeal lithotripsy in case of living donor prior to donation, ex vivo approach (pyelotomy or ureteroscopy), ureterocopy in the KTx recipient or surveillance. De novo kidney stones result from a lithogenesis process to be identified and treated in order to avoid recurrences. The context of solitary functional kidney renders the prevention of recurrence of great importance. Diagnosis is suspected when identification of a renal graft dysfunction, hematuria or urinary tract infection with renal pelvis dilatation. Stone size and location are determined by computed tomography. There are no prospective, controlled studies on kidney stone management in the KTx. The therapeutic strategies are similar to standard management in general population. CONCLUSION These French recommendations should contribute to improve kidney stones management in KTx donor and recipients.
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Affiliation(s)
- T Bessede
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, université Paris Saclay, hôpital de Bicêtre, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - J Branchereau
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU de Nantes, 5, allée de l'Ile Gloriette, 44093 Nantes cedex 01, France
| | - A Goujon
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation rénale, hôpital Pontchaillou, CHU de Rennes, 2, rue Henri-le-Guilloux, 35000 Rennes, France
| | - R Boissier
- Service d'urologie et transplantation, université Aix-Marseille, hôpital de la Conception, 47, boulevard Baille, 13005 Marseille, France
| | - E Alezra
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation rénale, CHU de Bordeaux, place Amélie-Raba-Léon, 33000 Bordeaux, France
| | - G Verhoest
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation rénale, hôpital Pontchaillou, CHU de Rennes, 2, rue Henri-le-Guilloux, 35000 Rennes, France
| | - T Culty
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation rénale, CHU d'Angers, 4, rue Larrey, 49100 Angers, France
| | - X Matillon
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, hôpital Edouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France
| | - A Doerfler
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU Brugmann, place A. Van Gehuchten 4, 1020 Bruxelles, Belgique
| | - X Tillou
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France
| | - F Sallusto
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU de Toulouse, 9, place Lange, 31300 Toulouse, France
| | - N Terrier
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU Grenoble Alpes, boulevard de la Chantourne, 38700 La Tronche, France
| | - R Thuret
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation rénale, hôpital Lapeyronie, CHU de Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34070 Montpellier, France
| | - S Drouin
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, université Paris Sorbonne, hôpital de la Pitié-Salpêtrière, 47, boulevard de l'Hôpital, 75013 Paris, France
| | - M-O Timsit
- Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Inserm, équipe labellisée par la ligue contre le cancer, université de Paris, PARCC, 56, rue Leblanc, 75015 Paris, France; Service d'urologie et transplantation rénale, hôpital européen Georges-Pompidou, hôpital Necker, Assistance publique-Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France.
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Gambaro G, Zaza G, Citterio F, Naticchia A, Ferraro PM. Living kidney donation from people at risk of nephrolithiasis, with a focus on the genetic forms. Urolithiasis 2018; 47:115-123. [PMID: 30470867 DOI: 10.1007/s00240-018-1092-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 11/08/2018] [Indexed: 02/03/2023]
Abstract
Deciding whether to accept a donor with nephrolithiasis is a multifaceted task because of the challenge of finding enough suitable donors while at the same time ensuring the safety of both donors and recipients. Until not long ago, donors with a history of renal stones or with stones emerging during screening on imaging were not considered ideal, but recent guidelines have adopted less stringent criteria for potential donors at risk of stones. This review goes through the problems that need to be approached to arrive at a wise clinical decision, balancing the safety of donors and recipients with the need to expand the organ pool. The risk of declining renal function and worsening stone formation is examined. Documents (consensus statements, guidelines, etc.) on this issue released by the most important medical societies and organizations are discussed and compared. Specific problems of living kidney donation associated with certain systemic (chronic hypercalcemia due to CYP24A1 gene mutations, primary hyperoxaluria, APRT deficiency) and renal (medullary sponge kidney, cystinuria, distal renal tubular acidosis, Dent's disease, Bartter syndrome, familial hypomagnesemia with hypercalciuria and nephrocalcinosis) Mendelian disorders that cause nephrolithiasis are also addressed.
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Affiliation(s)
- Giovanni Gambaro
- UOC Nefrologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. .,Renal Unit, Department of Medicine, University Hospital of Verona, Verona, Italy. .,Università Cattolica del Sacro Cuore, Via G. Moscati 31, 00168, Rome, Italy.
| | - G Zaza
- Renal Unit, Department of Medicine, University Hospital of Verona, Verona, Italy
| | - F Citterio
- UOSA Trapianto di rene, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Via G. Moscati 31, 00168, Rome, Italy
| | - A Naticchia
- UOC Nefrologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Via G. Moscati 31, 00168, Rome, Italy
| | - P M Ferraro
- UOC Nefrologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Via G. Moscati 31, 00168, Rome, Italy
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