Living kidney donation does not adversely affect serum calcification propensity and markers of vascular stiffness

Living kidney donors (LKDs) experience a decline in glomerular filtration rate (GFR) after donation. Calcification propensity (T₅₀) can be determined by a blood test predicting all‐cause mortality in patients with chronic kidney disease. We studied the impact of kidney donation on T₅₀ and markers of arterial stiffness. We analyzed T₅₀ prospectively before and 1 year after kidney donation in 21 LKDs along with fetuin‐A, mineral metabolism markers, kidney length, pulse wave velocity (PWV), augmentation index (AI), and renal resistive index (RRI) as markers of arterial stiffness. We studied the impact of kidney donation on these parameters. LKDs were 54 ± 10 years old and had a GFR of 101 ± 18 ml/min/1.73 m² before donation, decreasing to 67 ± 8 ml/min/1.73 m² after donation (P < 0.001). Despite this, T₅₀ improved after donation (290 ± 53 to 312 ± 38 min, P = 0.049). This change was inversely related to plasma phosphate (P = 0.03), which declined after donation (P = 0.002). Fetuin‐A levels increased after donation (P = 0.01). Upon donation, the length of the remaining kidney increased (P < 0.001) while PWV, AI, and RRI remained unchanged. Calcification propensity was not adversely affected by kidney donation. This indicates that T₅₀ is independent from GFR in LKDs and that kidney donation does neither worsen calcification propensity nor markers of vascular stiffness at 1 year.