Abstract: TH-PO1156
Early Post-Donation Hyperfiltration Is Associated with Accelerated Podocyte Detachment
Session Information
- Transplantation: Clinical - Pretransplant Management
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1902 Transplantation: Clinical
Authors
- Naik, Abhijit S., University of Michigan, Ann Arbor, Michigan, United States
- Le, Dustin, University of Michigan, Ann Arbor, Michigan, United States
- Wang, Su Qing, University of Michigan, Ann Arbor, Michigan, United States
- Chowdhury, Mahboob A., University of Michigan, Ann Arbor, Michigan, United States
- Wiggins, Roger C., University of Michigan, Ann Arbor, Michigan, United States
Background
Living kidney donation is associated with increased long-term risk of CKD/ESRD post-donation. The remaining kidney is rarely biopsied and thus mechanisms behind progression remain unproven. Parallel data from uni-nephrectomized rat models shows podocyte hypertrophic stress, detachment and depletion, progressive proteinuria and FSGS. While proteinuria is common among donors vs. matched non-donors, it is often low grade
Methods
SpotUrine pellet mRNAs from 87 living donors were used. Data was normalized to creatinine for one podocyte markers (podocin), and urine protein. UPod:CR is a marker of podocyte detachment rate and UProt:CR as marker for proteinuria (both log transformed). We measured differences in UPod:CR, UProt:CR and eGFR before (day 0) and after donation (day 14) to estimate their "delta" values. Multivariable linear regression using either podocyte detachment or proteinuria were used as the dependent variable adjusted for baseline eGFR, donor age, BMI, MAP (Mean Arterial Pressure)at donation and the change in eGFR by 14 days post donation.
Results
In a multivariable linear regression model the change in eGFR by 14 days post donation was significantly associated with podocyte detachment rate but not proteinuria.
Conclusion
Early post donation hyperfiltration is associated with accelerated podocyte detachment even in the absence of proteinuria. Longer term follow up is required to understand relationship of hyperfiltration, podocyte detachment and progressive kidney dysfunction after donation.
| UPod:CR | B. Coef | Std. Err. | P value | LCL | UCL |
| Delta eGFR (ml/min) | 0.11 | 0.05 | 0.04 | 0.005 | 0.21 |
| Donor Age | 0.016 | 0.04 | 0.68 | -0.06 | 0.1 |
| BMI at Donation ( Kg/m2) | -0.01 | 0.09 | 0.89 | -0.19 | 0.16 |
| MAP before donation | -0.006 | 0.05 | 0.91 | -0.10 | 0.09 |
| Baseline eGFR | 0.07 | 0.04 | 0.12 | -0.02 | 0.15 |
Funding
- NIDDK Support