Effect of donor nephrectomy on markers of bone function in living kidney donors

Dialysis patients die from hardening of the arteries, related to changes in bone health called chronic kidney disease associated mineral bone disorder (CKD-MBD).  Understanding the mechanisms behind this is crucial to improving the length and quality of life. Most humans with early kidney disease have no symptoms and are unaware that they have a problem with their kidneys. They are unlikely to consult a doctor and early CKD is often unrecognised. Over the past decade living kidney donation has become increasingly common and is now the source of organs for more than 120 patients annually at Manchester’s renal transplant centre.  Prospective donors have normal kidney function and undergo a planned operation to lose approximately 50% of their kidney mass, creating an immediate state of moderate CKD and blood changes of alterations in bone health. Over time, the remaining kidney increases in size and all the changes of altered bone health normalises. Sequential changes in the plasma and urine levels of metabolites is called ‘Metabolomics’ and provides valuable new information to increase our understanding of the initial stage of CKD-MBD development.