Management of urolithiasis in living kidney donors

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Published Apr 19, 2019
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Vol. 97 No. 1 (2019): Issue Jan 2019

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Meriam Hajji
Lilia Ben Fatma
Hayet Kaaroud
Jaouida Abdelmoula
Mohammed Karim Zouaghi
Taieb Ben Abdallah

Abstract

Background : Kidney donors with asymptomatic stones were  previously excluded from the kidney donation list because of a potential increased morbidity risk for both the recipient and the donor. Currently, recent studies tend to consider these risks as overestimated.
Aim : The aim of this study was to analyze our experience in the management of urolithiasis in potential donors.
Methods : We conducted a retrospective analysis during the period (2008-2015). We included donors with urilithiasis or a family history of urolithiasis whom had urinary biochemical analysis of urolithiasis. We identified the exact location, size, and anatomy of the kidney bearing the stone were identified.
Results: Among 252 potentially proposed living kidney donors (LKD) in two renal transplantation centers, we noted urinary lithiasis in 8 patients (3.17%). The mean age was 40,12±20 years old with a sex-ratio M/F at 0,3. We noted urinary lithiasis on radiographs in one case, on echographs in one case and on computerized tomography kidney angiography in 5 cases. All are not obese and without any medical history. In one case, there was no lithiasis detected but chemical urinary analysis was performed because of family renal stone history. We performed a 24-hours urine test, and examined PH, calcium and oxalate. The urine analysis, showed acidic pH and hypercalciuria in all cases associated to weddelite in 3 cases, hyperoxaluria in all cases. In one case, we noted vitamin D deficiency related hyperparathyroidism. Renal transplantation has been achieved in two cases. After a mean follow up of 11,25 months [range :27-84], no urological complications were noted.
Conclusion : Urinary lithiasis may occur in proposed living kidney donors and may not contraindicate this donation.

Keywords:

Living Kidney donor; Kidney transplantation; lithiasis

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References

  1. Vasdev N, Moir J, Dosani M, Williams R, Soomro N, Talbot D, et al. Endourological Management of Urolithiasis in Donor Kidneys prior to Renal Transplant. ISRN Urol 2011. doi:10.5402/2011/242690.
  2. M. S. Rezaee-Zavareh, R. Ajudani, M. Ramezani Binabaj, et al. Kidney Allograft Stone after Kidney Transplantation and its Association with Graft Survival. Int J Organ Transplant Med 2015;6[3]:114-8.
  3. Elizabeth C. Lorenz, John C. Lieske, Terri J. Vrtiska, et al. Clinical characteristics of potential kidney donors with asymptomatic kidney stones. Nephrol Dial Transplant 2011;26 [8]: 2695-700.
  4. Burgher A, Beman M, Holtzman JL, et al. Progression of nephrolithiasis: long-term outcomes with observation of asymptomatic calculi. Journal of Endourology 2004;18[6]:534-9.
  5. Bhadauria RP, Ahlawat R, Kumar RV, Srinadh ES, Banerjee GK, Bhandari M. Donor-gifted allograft lithiasis: extracorporeal shockwave lithotripsy with over table module using the Lithostar Plus. Urologia Internationalis 1995;55[1]:51-5.
  6. Van Gansbeke D, Zalcman M, Matos C, Simon J, Kinnaert P, Struyven J. Lithiasic complications of renal transplantation: the donor graft lithiasis concept. Urologic Radiology 1985;7[3]:157-160.
  7. Qazi YA, Ali Y, Venuto RC, et al. Donor calculi induced acute renal failure. Renal Failure 2003;25[2]:315-322.
  8. Rashid MG, Konnak JW, Wolf JS, et al. Ex vivo ureteroscopic treatment of calculi in donor kidneys at renal transplantation. Journal of Urology 2004;171[1]:58-60.
  9. Trivedi A, Patel S, Devra A, Rizvi J, Goel R, Modi P. Management of calculi in a donor kidney. Transplant Proc 2007;39[3]:761-2.
  10. Olsburgh J, Thomas K, Wong K, Bultitude M, Glass J, Rottenberg G. Incidental renal stones in potential live kidney donors: prevalence, assessment and donation, including role of ex vivo ureteroscopy. BJU Int 2013;111[5]:784-92.
  11. Rizkala E, Coleman S, Tran C, et al. Stone disease in living-related renal donors: long-term outcomes for transplant donors and recipients. J Endourol 2013;27:1520-4.
  12. CaliskanY, Yildiz A. Evaluation of the Medically Complex Living Kidney. Journal of Transplantation. 2012. doi.org/10.1155/2012/450471.
  13. Stamatelou KK, Francis ME, Jones CA, et al. Time trends in reported prevalence of kidney stones in the United States: 1976-1994. Kidney Int 2003;63:1817-23.
  14. Soucie JM, Coates RJ, McClellan W, et al. Relation between geographic variability in kidney stones prevalence and risk factors for stones. Am J Epidemiol 1996;143:487-95.
  15. Curhan GC, Willett WC, Rimm EB, et al. Body size and risk of kidney stones. J Am Soc Nephrol 1998;9:1645-52.
  16. Taylor EN, Stampfer MJ, Curhan GC, et al. Obesity, weight gain, and the risk of kidney stones. JAMA 2005;293:455-62.
  17. Ennis J, Kocherginsky M, Schumm LP, et al. Trends in kidney donation among kidney stone formers: a survey of US transplant centers. Am J Nephrol 2009;30:12-8.
  18. Giessing M, Fuller F, Tuellmann M, et al. Attitude to nephrolithiasis in the potential living kidney donor: a survey of the German kidney transplant centers and review of the literature. Clin Transplant 2008;22:476-83.