Outcomes of Living Donors With Asymptomatic Nephrolithiasis.

Abstract

Background: Improved sensitivity of CT imaging has increased the prevalence of incidentally detected nephrolithiasis in potential living kidney donors(LKD). We compare the clinical outcomes in potential LKDs who were found to have incidental nephrolithiasis vs. LKDs without nephrolithiasis. Methods: 24 LKD candidates with incidental nephrolithiasis(study group) were identified; 20 donated(all laparoscopically). A control group of 26 LKDs without nephrolithiasis was identified. A questionnaire was administered to identify the frequency of: 1) symptoms/signs related to nephrolithiasis and 2)procedures needed for management of nephrolithiasis after either CT imaging(if no donation) or living donation Results: % of males, mean age, mean BMI, and mean follow-up time in the study and control groups were 20.8% and 34.6%, 48 and 40 years, 24.3 and 27.4, and 895 and 1106 days, respectively. Mean stone size of the largest stone in each patient of the study group was 3mm (range:0.25-9mm).Table: No Caption available.Conclusions: The risk of stone-related complications in individuals with asymptomatic nephrolithiasis identified by CT imaging during the donor evaluation process is not increased compared to individuals without nephrolithiasis. The presence of multiple stones or bilateral stones is not associated with an increased risk of stone-related complications. The presence of a stone >2mm to <9mm or a solitary kidney with nephrolithiasis may be associated with a lower post-donation GFR. A larger sample size, with longer follow-up, needs to be evaluated to confirm these preliminary findings.