Purpose: Living kidney donation is the preferred therapy for kidney transplant recipients and outcomes of living donors have been overall excellent. There are no histological studies on donors correlating demographic, physical findings such as obesity, and social risk factors (smoking, alcohol, and use of recreational drugs) with renal pathological findings. Methods:A retrospective analysis at Miami Transplant Institute was performed on 161 live kidney donor patients who had nephrectomy from January 2011 to September 2012 and a kidney biopsy at the time of surgery. Demographic data (age, race, sex), along with past medical history, GFR (MDRD), BMI, social history (smoking, alcohol consumption, use of recreational drugs) were analyzed and compared with pathology changes in the biopsies. For data analysis, a stepwise multiple and logistic regression model was used including t-tests and chi-squared tests. Results: We had a total of 161 living donors; 127 donors had biopsies. None of the donors were hypertensive. The % of male donors was 37.5%; non caucasian (black, hispanic or other) was 68.5 %; mean age was 39.2 ± 11.8; mean GFR 99.3 ± 19; mean BMI 27.0 ± 4.5. The % of patients that smoked was 26.6%, alcohol usage was 41.4%, and recreational drugs 5.5%. Biopsy results: median percentage of sclerotic glomeruli was 1.6 (0-30.4); 30.7% had more than 5% glomerular sclerosis; mild or minimal interstitial fibrosis and tubular atrophy (IFTA) was 29.1%, and arteriosclerosis was seen in 4.7%. Stepwise multiple regression model demonstrated a positive correlation between % of sclerotic glomeruli found and older age (>50 years) (P=0.002); similar findings were found with age and IFTA (P=0.009). No significant correlation existed between glomerular sclerosis, IFTA or vascular changes with BMI (P=0.47), alcohol consumption (p=0.82), smoking (P=0.69), use of recreational drugs (p=0.10), male gender (p=0.24), and non-Caucasian (p=0.64). Conclusions: Our study demonstrated that older donor age was the only sociodemographic factor that correlated with donor pathology. In this study the population was mainly non-Caucasian and may limit its generalization to other populations. This is one of the first large single center study that describes the correlation of pathology findings in kidney transplant donors with sociodemographic variables.

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