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Updated: Aug 14, 2026
Murine Kidney Transplant Technique
Published on: October 20, 2015
Persistent, asymptomatic, microscopic hematuria in prospective kidney donors
Rahul Koushik1, Catherine Garvey, J Carlos Manivel
1Departments of Medicine, Surgery, and Pathology, University of Minnesota, Minneapolis, MN 55455, USA. kidneycare@sbcglobal.net
Background:
Asymptomatic, microscopic hematuria is seen in 8-21% of the general population, has a good prognosis, and is generally not an indication for kidney biopsy. But whether it should preclude kidney donation is unclear.
Methods:
Of 512 consecutive prospective donors, 14 (2.7%) continued to have asymptomatic, microscopic hematuria over 1 month. If the medical history, physical examination, and computerized tomographic angiography were unremarkable, and if they still wished to donate, a kidney biopsy was performed.
Results:
In two prospective donors, hematuria resolved after treatment for urinary tract infection; two others declined donation and were referred to their primary care provider. Kidney biopsy in the remaining 10 showed: two normal; four thin basement membrane nephropathy (TBMN); one nonhomogeneous basement membrane abnormalities; one IgA nephropathy, 5 of 16 glomeruli globally sclerotic; one in a patient with a family history of Schimke's Syndrome, 7 of 30 glomeruli globally sclerotic; and one TBMN and early hypertensive changes without systemic hypertension. Only 4 of the 10 who underwent kidney biopsy donated (two normal, two TBMN).
Conclusions:
Kidney abnormalities are common in young, otherwise healthy, prospective kidney donor candidates with persistent, asymptomatic, microscopic hematuria. A kidney biopsy is often abnormal and aids in the decision-making process.
Insights
Persistent microscopic hematuria in kidney donors is common and often indicates underlying kidney abnormalities. Kidney biopsy is crucial for evaluating donor eligibility and guiding decisions.
Area of Science:
- Nephrology
- Transplantation
- Urology
Background:
- Asymptomatic microscopic hematuria affects 8-21% of the general population.
- It typically has a good prognosis and doesn't usually warrant a kidney biopsy.
- Its impact on kidney donation eligibility remains unclear.
Purpose of the Study:
- To investigate the prevalence and nature of kidney abnormalities in prospective kidney donors with persistent microscopic hematuria.
- To determine the utility of kidney biopsy in evaluating these donors.
Main Methods:
- 14 of 512 prospective donors (2.7%) had persistent asymptomatic microscopic hematuria.
- Donors with unremarkable medical history, physical exam, and CT angiography underwent kidney biopsy if they still wished to donate.
- Biopsy findings were analyzed to assess kidney health.
Main Results:
- Hematuria resolved in two donors after UTI treatment; two declined donation.
- Kidney biopsies in 10 donors revealed abnormalities in 8, including thin basement membrane nephropathy (TBMN) and IgA nephropathy.
- Only 4 of the 10 biopsied donors were ultimately able to donate (two normal, two TBMN).
Conclusions:
- Kidney abnormalities are prevalent in otherwise healthy prospective donors with persistent microscopic hematuria.
- Kidney biopsy is frequently abnormal and essential for informed decision-making regarding kidney donation.
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01:26Kidney Transplant II: Surgical Procedure
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:29Urine Studies I: Urinalysis