OBJECTIVE: To determine whether microstructural features on a kidney biopsy specimen obtained during kidney transplant surgery predict long-term risk of chronic kidney disease in the donor. PATIENTS AND METHODS: We studied kidney donors from May 1, 1999, through December 31, 2018, with a follow-up survey for the results of recent blood pressure and kidney function tests (estimated glomerular filtration rate [eGFR] and proteinuria). If not recently available, blood pressure and eGFRs were requested from a local clinic. Microstructural features on kidney biopsy at the time of donation were assessed as predictors of hypertension and kidney function after adjusting for years of follow-up, baseline age, sex, and clinical predictors. RESULTS: There were 807 donors surveyed a mean 10.5 years after donation. An eGFR less than 45 mL/min/1.73 m2 in 6.4% (43/673) of donors was predicted by larger glomerular volume per standard deviation (odds ratio [OR], 1.48; 95% CI, 1.08 to 2.04) and nephron number below the age-specific 5th percentile (OR, 3.38; 95% CI, 1.31 to 8.72). An eGFR less than 60 mL/min/1.73 m2 in 42.5% (286/673) of donors was not predicted by any microstructural feature. Residual eGFR (postdonation/predonation eGFR) was predicted by nephron number below the age-specific 5th percentile (difference, -6.07%; 95% CI, -10.24% to -1.89%). Self-reported proteinuria in 5.1% (40/786) of donors was predicted by larger glomerular volume (OR, 1.42; 95% CI, 1.08 to 1.86). Incident hypertension in 18.8% (119/633) of donors was not predicted by any microstructural features. CONCLUSION: Low nephron number for age and larger glomeruli are important microstructural predictors for long-term risk of chronic kidney disease after living kidney donation.
OBJECTIVE: To determine whether microstructural features on a kidney biopsy specimen obtained during kidney transplant surgery predict long-term risk of chronic kidney disease in the donor. PATIENTS AND METHODS: We studied kidney donors from May 1, 1999, through December 31, 2018, with a follow-up survey for the results of recent blood pressure and kidney function tests (estimated glomerular filtration rate [eGFR] and proteinuria). If not recently available, blood pressure and eGFRs were requested from a local clinic. Microstructural features on kidney biopsy at the time of donation were assessed as predictors of hypertension and kidney function after adjusting for years of follow-up, baseline age, sex, and clinical predictors. RESULTS: There were 807 donors surveyed a mean 10.5 years after donation. An eGFR less than 45 mL/min/1.73 m2 in 6.4% (43/673) of donors was predicted by larger glomerular volume per standard deviation (odds ratio [OR], 1.48; 95% CI, 1.08 to 2.04) and nephron number below the age-specific 5th percentile (OR, 3.38; 95% CI, 1.31 to 8.72). An eGFR less than 60 mL/min/1.73 m2 in 42.5% (286/673) of donors was not predicted by any microstructural feature. Residual eGFR (postdonation/predonation eGFR) was predicted by nephron number below the age-specific 5th percentile (difference, -6.07%; 95% CI, -10.24% to -1.89%). Self-reported proteinuria in 5.1% (40/786) of donors was predicted by larger glomerular volume (OR, 1.42; 95% CI, 1.08 to 1.86). Incident hypertension in 18.8% (119/633) of donors was not predicted by any microstructural features. CONCLUSION: Low nephron number for age and larger glomeruli are important microstructural predictors for long-term risk of chronic kidney disease after living kidney donation.
Authors: Elise Marechal; Adrien Jaugey; Georges Tarris; Michel Paindavoine; Jean Seibel; Laurent Martin; Mathilde Funes de la Vega; Thomas Crepin; Didier Ducloux; Gilbert Zanetta; Sophie Felix; Pierre Henri Bonnot; Florian Bardet; Luc Cormier; Jean-Michel Rebibou; Mathieu Legendre Journal: Clin J Am Soc Nephrol Date: 2021-12-03 Impact factor: 8.237
Authors: Aleksandar Denic; Marija Bogojevic; Aidan F Mullan; Moldovan Sabov; Muhammad S Asghar; Sanjeev Sethi; Maxwell L Smith; Fernando C Fervenza; Richard J Glassock; Musab S Hommos; Andrew D Rule Journal: J Am Soc Nephrol Date: 2022-08-03 Impact factor: 14.978
Authors: Panagiotis Korfiatis; Aleksandar Denic; Marie E Edwards; Adriana V Gregory; Darryl E Wright; Aidan Mullan; Joshua Augustine; Andrew D Rule; Timothy L Kline Journal: J Am Soc Nephrol Date: 2021-12-07 Impact factor: 10.121
Authors: Massini A Merzkani; Aidan Mullan; Aleksandar Denic; Matthew D'Costa; Ryan Iverson; Walter Kremers; Mariam P Alexander; Stephen C Textor; Sandra J Taler; Mark D Stegall; Joshua Augustine; Naim Issa; Andrew D Rule Journal: Clin Transplant Date: 2021-03-30 Impact factor: 3.456
Authors: Matthew R D'Costa; Massini A Merzkani; Aleksandar Denic; Aidan F Mullan; Joseph J Larson; Walter K Kremers; Walter D Park; Mariam P Alexander; Harini A Chakkera; Sandra J Taler; Stephen J Erickson; Mark D Stegall; Naim Issa; Andrew D Rule Journal: Transplant Direct Date: 2021-12-23