Microscopic Hematuria at Kidney Donor Screening and Post-Donation Kidney Outcomes
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Urinalyses and Definition of Microscopic Hematuria
2.3. Post-Donation Outcomes
2.4. Statistical Analyses
3. Results
3.1. Pre-Donation Characteristics of the Living Kidney Donor Population
3.2. Post-Donation Outcomes
3.3. Effect of Hematuria on Long-Term Post-Donation Proteinuria, SBP, and eGFR Course
3.4. Sensitivity Analyses
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Microscopic Hematuria | |||
---|---|---|---|
Total (n = 701) | Present (n = 88) | Absent (n = 613) | |
Female sex, n (%) | 345 (49) | 70 (80) | 275 (45) c |
Caucasian race, n (%) | 701 (100) | 88 (100) | 613 (100) |
Living related donations, n (%) | 328 (47) | 38 (43) | 290 (47) |
Age, years | 52 (11) | 54 (11) | 52 (11) |
Weight, kg | 81 (14) | 77 (13) | 81 (14) c |
Height, cm | 175 (9) | 171 (9) | 175 (9) b |
BMI, kg/m2 | 26 (4) | 26 (3) | 26 (4) |
BSA, m2 | 1.96 (0.20) | 1.89 (0.18) | 1.96 (0.20) b |
SBP, mmHg | 127 (13) | 125 (11) | 127 (13) |
DBP, mmHg | 76 (9) | 75 (9) | 76 (9) |
Hypertension a, n (%) | 183 (26) | 23 (26) | 160 (26) |
Use of antihypertensive medication, n (%) | 51 (7) | 5 (6) | 46 (8) |
mGFR, mL/min | 115 (22) | 111 (22) | 115 (22) b |
mGFRBSA, mL/min/1.73 m2 | 102 (16) | 101 (16) | 102 (16) |
eGFR, ml/min/1.73 m2 | 88 (14) | 88 (14) | 89 (14) |
Serum creatinine, µmol/L | 78 (14) | 72 (11) | 78 (14)c |
Serum glucose, mmol/L | 5.3 (0.6) | 5.3 (0.5) | 5.3 (0.6) |
HbA1C, % | 5.5 (0.4) | 5.5 (0.3) | 5.5 (0.4) |
Diabetes, n (%) | 6 (1) | 1 (1) | 5 (1) |
Serum cholesterol, mmol/L LDL HDL Triglycerides | 5.3 (1.0) 3.5 (0.9) 1.6 (0.5) 1.4 (0.9) | 5.3 (1.0) 3.4 (1.1) 1.7 (0.5) 1.2 (0.8) | 5.4 (1.0) 3.5 (0.9) 1.5 (0.5) 1.4 (0.9) b |
Serum urea, mmol/L | 5.4 (1.3) | 5.3 (1.2) | 5.5 (1.3) |
Serum potassium, mmol/L | 3.9 (0.3) | 3.9 (0.3) | 3.9 (0.3) |
Serum sodium, mmol/L | 141 (3) | 141 (3) | 141 (3) b |
Sodium excretion, mmol/24 h | 195 (73) | 172 (66) | 199 (73) b |
PCR, mg/mmol | 5 (0–12) | 9 (0–15) | 0 (0–12) |
erythrocytes per µL | n.a. | 10 (6–22) | n.a. |
Outcome PCR | Outcome eGFR | Outcome SBP | |||||||
---|---|---|---|---|---|---|---|---|---|
Estimate | 95% CI | P | Estimate | 95% CI | P | Estimate | 95% CI | P | |
Hematuria a | 0.28 | −0.01 to 0.56 | 0.05 | −1.17 | −3.66 to 1.32 | 0.36 | 1.18 | −1.86 to 4.22 | 0.45 |
Time | 0.04 | 0.03 to 0.05 | <0.001 | 0.34 | 0.23 to 0.44 | <0.001 | 0.92 | 0.75 to 1.09 | <0.001 |
Hematuria×time | −0.02 | −0.08 to 0.03 | 0.38 | 0.10 | −0.34 to 0.54 | 0.65 | 0.50 | −0.21 to 1.21 | 0.17 |
Outcome PCR | Outcome eGFR | Outcome SBP | |||||||
---|---|---|---|---|---|---|---|---|---|
Estimate | 95% CI | P | Estimate | 95% CI | P | Estimate | 95% CI | P | |
Hematuria a | 0.22 | −0.19 to 0.64 | 0.30 | −2.64 | −6.14 to 0.87 | 0.14 | 1.74 | −2.45 to 5.92 | 0.42 |
Time | 0.05 | 0.03 to 0.06 | <0.001 | 0.24 | 0.10 to 0.38 | 0.001 | 0.80 | 0.58 to 1.02 | <0.001 |
Hematuria×time | −0.02 | −0.10 to 0.06 | 0.66 | 0.41 | −0.18 to 0.99 | 0.17 | 0.002 | −0.89 to 0.90 | 0.996 |
Univariable | Multivariable | |||||
---|---|---|---|---|---|---|
St. β | 95% CI | P | St. β | 95% CI | P | |
Age, years | −0.52 | −0.64 to −0.45 | <0.001 | - | - | - |
Sex, 1 = female | −0.10 | −0.21 to 0.01 | 0.07 | 0.01 | −0.12 to 0.13 | 0.93 |
BMI, kg/m2 | −0.01 | −0.12 to 0.09 | 0.80 | - | - | - |
BSA, m2 | 0.07 | −0.04 to 0.16 | 0.22 | 0.01 | −0.11 to 0.12 | 0.93 |
eGFR, mL/min/1.73 m2 | 0.59 | 0.51 to 0.68 | <0.001 | 0.59 | 0.50 to 0.38 | <0.001 |
SBP, mmHg | −0.08 | −0.19 to 0.02 | 0.13 | −0.03 | −0.12 to 0.06 | 0.50 |
HbA1c, % | −0.08 | −0.19 to 0.04 | 0.19 | −0.09 | −0.19 to 0.01 | 0.07 |
ln(PCR), mg/mmol | −0.07 | −0.27 to 0.13 | 0.49 | - | - | - |
Hematuria, 1 = positive | −0.05 | −0.17 to 0.07 | 0.40 | −0.06 | −0.16 to 0.04 | 0.23 |
Univariable | Multivariable | |||||
---|---|---|---|---|---|---|
OR | 95% CI | P | OR | 95% CI | P | |
Outcome PCR group | ||||||
Hematuria, 1 = positive | 0.71 | 0.35 to 0.43 | 0.34 | 0.49 | 0.16 to 1.51 | 0.22 |
Age | 1.00 | 0.98 to 1.02 | 0.72 | 0.99 | 0.96 to 1.02 | 0.62 |
Female sex | 0.85 | 0.56 to 1.31 | 0.46 | 0.91 | 0.42 to 1.97 | 0.81 |
Pre-donation PCR | 1.03 | 0.53 to 2.00 | 0.93 | 1.11 | 0.53 to 2.34 | 0.78 |
Outcome eGFR group | ||||||
Hematuria, 1 = positive | 1.23 | 0.50 to 3.03 | 0.65 | 1.45 | 0.56 to 3.72 | 0.44 |
Age | 0.98 | 0.95 to 1.01 | 0.10 | 0.96 | 0.93 to 0.99 | 0.01 |
Female sex | 0.84 | 0.44 to 1.59 | 0.58 | 0.73 | 0.37 to 1.45 | 0.37 |
Pre-donation eGFR | 0.98 | 0.96 to 1.00 | 0.11 | 0.97 | 0.94 to 0.99 | 0.01 |
Outcome SBP group | ||||||
Hematuria, 1 = positive | 0.65 | 0.41 to 1.04 | 0.07 | 0.63 | 0.37 to 1.05 | 0.07 |
Age | 1.00 | 0.98 to 1.01 | 0.62 | 1.02 | 1.00 to 1.04 | 0.02 |
Female sex | 0.95 | 0.70 to 1.28 | 0.72 | 0.69 | 0.49 to 0.97 | 0.03 |
Pre-donation SBP | 0.94 | 0.92 to 0.95 | <0.001 | 0.93 | 0.92 to 0.95 | <0.001 |
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van der Weijden, J.; van Londen, M.; Pol, R.A.; Sanders, J.-S.F.; Navis, G.; Nolte, I.M.; de Borst, M.H.; Berger, S.P. Microscopic Hematuria at Kidney Donor Screening and Post-Donation Kidney Outcomes. J. Clin. Med. 2022, 11, 6281. https://doi.org/10.3390/jcm11216281
van der Weijden J, van Londen M, Pol RA, Sanders J-SF, Navis G, Nolte IM, de Borst MH, Berger SP. Microscopic Hematuria at Kidney Donor Screening and Post-Donation Kidney Outcomes. Journal of Clinical Medicine. 2022; 11(21):6281. https://doi.org/10.3390/jcm11216281
Chicago/Turabian Stylevan der Weijden, Jessica, Marco van Londen, Robert A. Pol, Jan-Stephan F. Sanders, Gerjan Navis, Ilja M. Nolte, Martin H. de Borst, and Stefan P. Berger. 2022. "Microscopic Hematuria at Kidney Donor Screening and Post-Donation Kidney Outcomes" Journal of Clinical Medicine 11, no. 21: 6281. https://doi.org/10.3390/jcm11216281