A long term study spanning a quarter of a century explored how becoming a kidney donor affects bone health. The researchers found that donors had a lower overall risk of fractures compared with the general population, yet they faced a higher chance of spinal fractures. The findings were published in JAMA Network Open.
The investigation followed 2,132 living kidney donors and compared them with 2,014 healthy adults of similar age who did not donate. On average, the donors were followed for about 24.2 years, while non-donors were observed for about 27.6 years. Roughly six in ten participants in both groups were women, and the average age at the study’s end was near 70 years old. These figures place the study in the landscape of long term, population level research and help clarify how kidney donation might shape bone health later in life as people age.
The bottom line from the analysis is nuanced. Kidney donors showed a lower overall incidence of fractures than their peers who did not donate. Yet spinal fractures appeared more frequently among donors. The team suggests a possible mechanism tied to the loss of kidney mass over time and the development of chronic hyperparathyroidism. This condition means higher levels of parathyroid hormone, which can thin bones and weaken vertebrae, contributing to vertebral fractures and a reduction in cancellous bone density. This explanation aligns with what clinicians observe in bone metabolism when kidney mass declines and mineral balance shifts.
Earlier work in animal models has shown that antibiotics can restore jaw and hip bone loss in aged mice, a finding that adds to the broader discussion about bone health and systemic factors that affect bone integrity across different species. While these mouse studies are not a direct substitute for human data, they provide context for how interventions might influence bone remodeling processes over time. The current human findings emphasize the need for ongoing monitoring of bone health in living kidney donors, particularly focusing on spinal health as donors age. These insights can inform postdonation care plans and encourage proactive measures to maintain bone strength, such as nutrition, exercise, and appropriate medical screening, when applicable.