Abstract: PO0478
Living Kidney Donors from a Hotspot for CKD of Unknown Origin
Session Information
- CKD Risk Factors: Diet, Environment, Lifestyle
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Armenta álvarez, Armando, National Institute of Cardiology, Instituto Nacional de Cardiologia, México, Mexico City, CDMX, Mexico
- Pacchiano, Lillana, National Institute of Cardiology, Instituto Nacional de Cardiologia, México, Mexico City, CDMX, Mexico
- Rodríguez, Francisco, National Institute of Cardiology, Instituto Nacional de Cardiologia, México, Mexico City, CDMX, Mexico
- Madero, Magdalena, National Institute of Cardiology, Instituto Nacional de Cardiologia, México, Mexico City, CDMX, Mexico
Group or Team Name
- Nephrology Deparment, National Institute of Cardiology, Ignacio Chávez, México.
Background
Tierra Blanca region has been identified as a Chronic Kidney Disease of unknown origin (CKDu) hotspot. At the National Heart Institute 52 young patients with CKDu from Tierra Blanca have been transplanted from living kidney donors from the same area The objective of the study was to determine the prevalence of decreased kidney function in living kidney donors from Tierra Blanca
Methods
Medical records from 1995 to 2019 were reviewed in order to obtain anthropometric measurements, occupation, past medical history and family history Laboratory data included serum creatinine (SCr), albumin-creatinine ratio (ACR), 24 hour urinary protein-creatinine ratio (PCR), at baseline and at 1,3,5, and 10 years. Time zero kidney biopsies were obtained in a subset of the cohort. eGFR ACR and PCR were used as indicators of kidney function
Results
32 patients were included the mean age was 36 ± 10 y and mean eGFR at donation was 95.1±15.5 mL/min. 35% worked in agriculture 50% in household 6% in construction 6% in a storage company 3% unemployed. The mean change in eGFR at 1, 3, 5, and 10 years was - 18.2 ± 12.4, -7.5 ± 19.8, -6.9 ± 19, -8.1 ± 11.9ml/min.
There was a significant difference between agriculture and domestic workers in eGFR decrease at 5 and 10 years. 50% underwent time zero biopsy and 69 % had some evidence of histological damage 62% showed glomerular abnormalities 40% had glomerular sclerosis, tubulointerstitial infiltrates 31% interstitial fibrosis 50% and either medial hypertrophy or intimal fibrosis 69 % These findings were not associated to occupation
In multivariate analysis using a lineal model of repetitive measurements, working in agriculture was the most important risk factor associated to eGFR decrease (p= .023)
Conclusion
Baseline histological changes were observed in the majority of the kidney donors, Agricultural work was the most important risk factors for eGFR decline