Kidney Week

Abstract: SA-PO975

Relationship between New-Onset Proteinuria and Remnant Kidney Hypertrophy and/or Pre-donated Kidney Volumes

Session Information

• Transplantation: Clinical - 3
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2102 Transplantation: Clinical

Authors

• Ogata, Masatomo, St. Marianna University School of Medicine, Kawasaki, Japan

Masatomo Ogata, MD

• Miyauchi, Takamasa, St. Marianna University School of Medicine, Kawasaki, Japan

Takamasa Miyauchi, MD

• Osako, Kiyomi, St. Marianna University School of Medicine, Kawasaki, Japan

Kiyomi Osako, MD

• Imai, Naohiko, St. Marianna University School of Medicine, Kawasaki, Japan

Naohiko Imai, MD, PhD, FASN

• Sakurai, Yuko, St. Marianna University School of Medicine, Kawasaki, Japan

Yuko Sakurai, PharmD

• Shinoda, Kazunobu, St. Marianna University School of Medicine, Kawasaki, Japan

Kazunobu Shinoda, DrMed, DrPH

• Shibagaki, Yugo, St. Marianna University School of Medicine, Kawasaki, Japan

Yugo Shibagaki, MD

• Yazawa, Masahiko, St. Marianna University School of Medicine, Kawasaki, Japan

Masahiko Yazawa, MD, PhD

Background

Some living kidney donors (LKDs) develop proteinuria, which is generally associated with end-stage kidney disease. Previous reports have shown new-onset proteinuria correlates with preoperative preserved kidney volume (PKV) and remnant kidney hypertrophy (%PKV change). We explored the association between the combination of preoperative PKV and %PKV change after donation and new-onset of proteinuria.

Methods

This single-center, retrospective, observational study included eligible LKDs who donated kidneys between January 2008 and July 2022 (N=195). Of these, 71 LKDs who had their PKV calculated via non-contrast computed tomography (CT) volumetry before and 1 year after donation and who were evaluated for proteinuria were included. They were divided into four groups according to the mean body surface area (BSA)-adjusted PKV (large [LKV] and small [SKV]) and mean %PKV change (hypertrophy [KH] and non-hypertrophy[non-KH]), and the association with new-onset proteinuria was investigated. Time-to-event analysis was performed using log-rank tests. Significant factors for event occurrence were calculated using Cox proportional hazards model adjusted by age and sex.

Results

Mean age was 59.7 ± 7.9 years and 71.8% were female (N=51). The mean %PKV change and BSA-adjusted PKV were 20.3 ± 7.0%, and 161.6 ± 24.0 cm³, respectively. During the 2.3 years follow-up period (mean), the LKV/non-KH group had significantly higher proteinuria events than the other groups (log-rank test, p = 0.039). The LKV/non-KH group had a significantly higher hazard ratio (HR) of new-onset proteinuria than the SKV/KH group （adjusted HR: 2.87, 95% confidence interval: 1.03–8.06）.

Conclusion

Post-donated proteinuria is more likely to occur in kidneys already enlarged before donation and is not sufficiently hypertrophic change after donation in LKDs. This imaging study before and shortly after donation might authorize personalized follow-up in LKDs.