<p>Dietary Supplement Use in Live Kidney Donors and Recipients</p>

Abstract

Background: Dietary supplement use in living kidney donors (LKDs) and kidney transplant recipients (KTRs) provides care challenges due to drug interactions, limited data, and lack of management guidelines. The study purposes were to describe supplement use patterns and intra/postoperative complications in these populations. Methods: A single-center retrospective review of LKDs and KTRs from September 2016-2018 was conducted. Supplement information was collected at evaluation and preoperative visits. Supplement relationship to intra/postoperative complications was graded by Naranjo Adverse Drug Reaction Probability Scale. Results: One hundred and fifty-seven LKDs met inclusion with an average age of 45 (SD 11) years. Thirty-seven LKDs (24%) reported supplement use pre-donation. One hundred and eleven KTRs met inclusion with an average age of 46 (SD 13) years and 21 (19%) reported supplement use pre-transplant. No significant differences in sex, ethnicity, or education were found between LKDs or KTRs using supplements vs none. One complication in an LKD was "possibly" related to supplement use vs none in KTRs. Conclusion: Transplant providers should screen for supplement use in LKDs and KTRs at both the evaluation and pre-operative visits and review perioperative management. The low dietary supplement-related intra/post complication rate may be due to discontinuation of supplements preoperatively.

Retrospective assessment of medication patterns among candidates evaluated for living kidney donation

“…A prior study of LKDs from our center identified a pre-donation dietary supplement prevalence of 24%. 7 The current study identified dietary supplement use among half of LKDs; however, the classification of dietary supplements in our study included micronutrients (vitamins/minerals) which were excluded in our prior study. Unlike prescription and over-the-counter medications, dietary supplements are not regulated by the U.S. Food and Drug Administration and are not subject to the same scrutiny regarding their efficacy, safety, and purity.…”

“…21 Similar studies have found greater supplement identification with transplant pharmacist-conducted medication histories, underscoring the value of an interdisciplinary, team-based approach. 7,22 With frequent use of dietary supplements among LKD candidates, appropriate identification and counseling are imperative to maintain the health of these patients as well as preserve the renal function of the unilateral kidney.…”

“…10 Supplements were defined as oral herbal or nutritional products, as well as micronutrients (vitamins/minerals). 7 Secondary outcomes included comparing the frequency of medication classes between LKD candidates approved and declined for donation. As candidates declined for donation did not progress toward a preoperative visit, medication lists generated solely from the evaluation visit were used to compare candidates who were approved and declined for donation.…”

“…5,6 Our center previously assessed dietary supplement use among LKDs and recipients and found that 24% and 19% of individuals reported taking a dietary supplement at any point before donation and transplant, respectively. 7 Data for prescription and overthe-counter medications among LKD candidates, including those declined for donation, is lacking in the literature. Transplant pharmacists play an integral role in LKD medication reconciliation, education, and management in the evaluation, donation, and post-operative management phases of care.…”

“…Data on medication use among LKDs in the evaluation phase is sparse 5,6 . Our center previously assessed dietary supplement use among LKDs and recipients and found that 24% and 19% of individuals reported taking a dietary supplement at any point before donation and transplant, respectively 7 . Data for prescription and over‐the‐counter medications among LKD candidates, including those declined for donation, is lacking in the literature.…”