Short-term mineral metabolism adaptation in living kidney donors: A prospective study

Abstract

Background: Living kidney donors (LKDs) show an abrupt decline in glomerular filtration rate (GFR) however, mineral metabolism adaptations in early chronic kidney disease (CKD) are still debated and not well studied in LKDs. We prospectively studied short term mineral metabolism adaptation of LKDs. Material and Methods: From January 2017 to April 2017, we included 36 adult LKDs. Their mineral parameters and renal function were repeatedly measured at days 0 and day 30 after kidney donation. Results: In the 1st month after nephrectomy, urinary phosphate reabsorption increased nonsignificantly in spite of significant increase in circulating fibroblast growth factor 23 (FGF23). LKDs have lower estimated GFR (eGFR) and unchanged 1,25-dihydroxyvitamin D (25(OH) 2D). Conclusion: Short-term mineral metabolism adaptations to decreased eGFR in donors include unchanged 25(OH) 2D unchanged fractional excretion of phosphate and increase in phosphate reabsorption with significant increase in FGF23. These adaptations differ from those described in CKD patients.

Keywords

• chronic kidney disease
• fibroblast growth factor 23
• living kidney donors