Persistent, asymptomatic, microscopic hematuria in prospective kidney donors

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.