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Histopathologic Findings of Potential Kidney Donors With Asymptomatic Microscopic Hematuria: Impact on Donation
E A Hassan1, T Z Ali2, A Abdulbaki2
1Adult Transplant Nephrology, Department of Kidney & Pancreas Transplantation, King Faisal Specialist Hospital & Research Centre, Riyadh, Kingdom of Saudi Arabia; Department of Nephrology, Fayoum University, Fayoum, Egypt.
Introduction:
Isolated microscopic hematuria (IMH) is not uncommon in potential kidney donors.
Aim:
The aim was to study the kidney biopsy findings of potential kidney donors with IMH and the impact of the histopathologic diagnoses on the decision to accept or decline such donors from kidney donation.
Methods:
In this retrospective study, all the potential kidney donors with IMH were identified from the medical records of patients who underwent kidney biopsies between January 2010 and December 2016.
Results:
Forty-five such individuals were identified. The mean age of these potential donors was 32.6 years and 76% were male. All of them had normal blood pressure and no significant proteinuria. Seventeen (38%) biopsies showed histopathologic abnormalities; thin basement membrane disease (n = 13; 28%) was the most common cause followed by immunoglobulin (Ig)A nephropathy (n = 4; 9%). Donors with abnormal biopsy findings were excluded from donation. However, 62% of the potential donors had normal kidney biopsy findings and were accepted for kidney donation.
Conclusion:
IMH justifies extensive work-up including kidney biopsy to identify donors who may have underlying significant glomerular pathology excluding them from kidney donation. On the other hand, kidney biopsy also helps in accepting the donors if it does not show significant abnormality.
Insights
Isolated microscopic hematuria (IMH) in potential kidney donors often requires kidney biopsy. Biopsy findings determine donor eligibility, with abnormalities leading to exclusion and normal results allowing donation.
Area of Science:
- Nephrology
- Transplantation Immunology
- Medical Diagnostics
Background:
- Isolated microscopic hematuria (IMH) is a common finding in individuals considered for kidney donation.
- Evaluating IMH is crucial for ensuring the long-term health of both the donor and recipient.
Purpose of the Study:
- To investigate kidney biopsy findings in potential kidney donors presenting with IMH.
- To assess the impact of histopathologic diagnoses on donor acceptance or declination for kidney donation.
Main Methods:
- A retrospective analysis of medical records was conducted.
- Identified potential kidney donors with IMH who underwent kidney biopsies between January 2010 and December 2016.
Main Results:
- Out of 45 identified potential donors, 38% showed histopathologic abnormalities on kidney biopsy.
- Thin basement membrane disease (28%) and IgA nephropathy (9%) were the most frequent diagnoses in abnormal biopsies.
- 62% of potential donors had normal kidney biopsies and were accepted for donation, while those with abnormalities were excluded.
Conclusions:
- Kidney biopsy is essential for identifying significant glomerular pathology in potential donors with IMH, guiding exclusion decisions.
- Normal kidney biopsy findings in donors with IMH support their acceptance for kidney donation, ensuring donor safety.
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