Glomerular Hematuria in Living Kidney Donors Confers a Risk of Kidney

Glomerular Hematuria in Living Kidney Donors Confers a Risk of Kidney Disease

American Journal of Transplantation
Volume 10 Issue 7, Pages 1597 - 1604
Published Online: 26 Mar 2010

Persistent Glomerular Hematuria in Living Kidney Donors Confers a Risk of Progressive Kidney Disease in Donors After Heminephrectomy
R. Kido a,*, Y. Shibagaki b , K. Iwadoh c , I. Nakajima c , S. Fuchinoue c , T. Fujita a and S. Teraoka c
a Department of Nephrology and Endocrinology, University of Tokyo, Graduate School of Medicine, Tokyo, Japan b Division of Nephrology and Hypertension, St. Marianna University, School of Medicine, Kanagawa, Japan c Department of Surgery, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan
* Corresponding author: Ryo Kido, Ryo.kido@mb5.seikyou.ne.jp

ABSTRACT
Although glomerular hematuria is likely a sign of chronic kidney disease that will develop into overt nephropathy after donation, it remains unclear whether prospective donors with hematuria should be excluded. We reviewed the medical records of 242 donors who donated at our institution from 2001 to 2007 and surveyed the prevalence of hematuria pre- and postdonation. We then investigated the association of hematuria with proteinuria postdonation and trends in glomerular filtration rate. Before donation, 8.3% of 242 donors presented with persistent hematuria, a finding that was significantly associated with dysmorphic hematuria before donation. Most cases of predonation persistent hematuria persisted after donation, and the overall prevalence increased to 15.3%. During a median follow-up period of 2.3 years after donation, 8.3% developed persistent proteinuria, with incidence being significantly higher in donors having persistent hematuria with dysmorphic red blood cells (d-RBC) both before and after donation. Postdonation persistent hematuria with d-RBC was also associated with a progressive decline in renal function. These results indicate that persistent glomerular hematuria is strongly associated with a higher incidence of postdonation progressive kidney disease. Potential donors with persistent glomerular hematuria should be excluded, while those with isolated hematuria need to be evaluated with heightened caution.

DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1600-6143.2010.03077.x

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