Prediction of Renal Function in Living Kidney Donors and Recipients of Living Donor Kidneys Using Quantitative Histology.

Autor:	Buus NH; Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark.; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark., Nielsen CM; Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark.; Core Center for Molecular Morphology, Section for Stereology and Microscopy, Aarhus University Hospital, Aarhus, Denmark., Skov K; Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark., Ibsen L; Department of Radiology, Aarhus University Hospital, Aarhus, Denmark., Krag S; Department of Pathology, Aarhus University Hospital, Aarhus, Denmark., Nyengaard JR; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.; Core Center for Molecular Morphology, Section for Stereology and Microscopy, Aarhus University Hospital, Aarhus, Denmark.
Jazyk:	angličtina
Zdroj:	Transplantation [Transplantation] 2023 Jan 01; Vol. 107 (1), pp. 264-273. Date of Electronic Publication: 2022 Jul 27.
DOI:	10.1097/TP.0000000000004266
Abstrakt:	Background: Living kidney donors (LKDs) are at increased risk of chronic kidney disease, whereas transplant recipients experience progressive reduction of graft function. We examined the predictive value of quantitative stereology on renal function in LKDs and recipients of living donor kidneys, based on perioperative biopsies from the donated kidney. Methods: Cortex volume of both donor kidneys was determined by contrast-enhanced computed tomography and single-kidney glomerular filtration rate (GFR) by 51 chrome-EDTA clearance together with renography. Glomerular density was used to estimate total glomeruli number in addition to glomerular volume, glomerular sclerosis, kidney fibrosis, and arteriole dimensions. GFR measurements were repeated 1 y after transplantation in both LKDs and recipients. Associations between GFR at follow-up and cortex volume and histomorphometric parameters after adjustment of age, gender, body mass index, smoking status, 24-h blood pressure, and single-kidney GFR were examined. Results: We included 49 LKDs (age, 51 ± 12 y) and 51 recipients (age, 44 ± 13 y). At follow-up, GFR was 71 ± 16 mL/min in LKDs and 61 ± 18 mL/min in recipients with hyperfiltration being more prominent in LKDs (30.4%) as compared to recipients (16.4%; P < 0.05). One-year GFR in donors correlated to cortex volume ( P < 0.001) but not to any histological parameters, whereas GFR in recipients correlated to the amount of interstitial fibrosis ( P < 0.01) but not to other histological parameters or cortex volume. Conclusions: Kidney cortex volume, but not renal histology parameters, predicts 1-y renal outcome in LKDs. In contrast, the amount of interstitial fibrosis, but not cortex volume, predicts 1-y graft function in recipients. Competing Interests: The authors declare no conflicts of interest. The results presented in this article have not been previously published in whole, but data examples from a few individuals have been presented in a methodological article (Nielsen CM, Skov K, Buus NH, et al. Kidney structural characteristics based on a kidney biopsy and contrast-enhanced computed tomography in healthy living kidney donors. Anat Rec (Hoboken ). 2020;303:2693–2701). (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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