Kidney Structural Characteristics as Predictors of Long-Term Kidney Function in Living Kidney Donors.
1Nephrology, Mayo Clinic, Rochester, MN
2Pathology, Mayo Clinic, Rochester, MN
3Radiology, Mayo Clinic, Rochester, MN
4Nephrology, Mayo Clinic, Scottsdale, AZ.
Meeting: 2016 American Transplant Congress
Abstract number: 537
Keywords: Donation, Histology, Image analysis, Renal function
Session Information
Session Name: Concurrent Session: Living Kidney Donor Evaluation
Session Type: Concurrent Session
Date: Tuesday, June 14, 2016
Session Time: 4:30pm-6:00pm
Presentation Time: 5:42pm-5:54pm
Location: Ballroom B
Purpose
Kidney structural characteristics may be predictive of long-term living donor outcomes such as a lower estimated Glomerular Filtration Rate (eGFR).
Methods
As part of the Renal and Lung Living Donors Evaluation (RELIVE) Study, kidney donors with implantation biopsies and pre-donation CT scans were studied for long-term outcomes at least 5 years after donation by a serum creatinine based eGFR with the CKD-EPI equation. There were 868 living donors during the time period 2000-2005, of which, 391 (45%) participated with a follow-up serum creatinine. Of these 391 donors, 334 had macro-structural measures of the retained kidney at baseline by pre-donation CT scan (cortical volume and surface roughness) and 268 had micro-structural measures of the implantation biopsy of the donated kidney by morphometry, stereology, and pathologist review. Nephron number was estimated from cortical volume [times] glomerular density.
Results
On CT, the mean cortical volume was 105 cc and kidney surface roughness was 0.9 (range 0 to 3). On biopsy, the mean glomerular density was 14 per mm3, glomerular volume was 0.0028 mm3, % intimal occlusion was 32%, and nephron number was 813,382; any interstitial fibrosis and tubular atrophy occurred in 24% and any glomerulosclerosis in 35%. At follow-up, a mean 7.9 years after donation (mean age of 54 years), the mean eGFR was 67 (31% were 45-59 and 3.5% were <45 ml/min/1.73 m2. Association of kidney structural findings at donation with follow-up eGFR is shown in the Table.
Conclusion
Cortical volume of the retained kidney may have utility for predicting long term kidney function in donors.
| Clinical and structural predictors of long-term eGFR in donors | ||||
|
Baseline Predictor (per SD if continuous) |
||||
| Unadjusted | Age-adjusted | |||
| Beta | P value | Beta | P value | |
| Age | –7.1 | <0.001 | ||
| Cortical volume | 3.1 | <0.001 | 2.3 | 0.002 |
| Cortex surface roughness | -1.8 | 0.04 | -0.5 | 0.53 |
| Glomerular density | 0.3 | 0.08 | 0.4 | 0.60 |
| Glomerular volume | 0.2 | 0.82 | 0.5 | 0.52 |
| % Interstitiall fibrosis | -3.2 | 0.002 | -1.1 | 0.22 |
| # of tubular atrophy foci | -3.5 | 0.003 | -0.7 | 0.49 |
| % Glomerulosclerosis | -4.2 | <0.001 | -0.9 | 0.41 |
| % intimal occlusion | -2.7 | 0.005 | -1.0 | 0.25 |
| Nephron number | 3.1 | 0.002 | 1.3 | 0.14 |
CITATION INFORMATION: Mathew J, Denic A, Alexander M, Vrtiska T, Chakkera H, Taler S, Rule A. Kidney Structural Characteristics as Predictors of Long-Term Kidney Function in Living Kidney Donors. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Mathew J, Denic A, Alexander M, Vrtiska T, Chakkera H, Taler S, Rule A. Kidney Structural Characteristics as Predictors of Long-Term Kidney Function in Living Kidney Donors. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/kidney-structural-characteristics-as-predictors-of-long-term-kidney-function-in-living-kidney-donors/. Accessed November 22, 2024.« Back to 2016 American Transplant Congress