Department of Kidney Disease Center, Nagoya Daini Red Cross Hospital, Nagoya, Japan,
Department of Kidney Disease Center, Nagoya Daini Red Cross Hospital, Nagoya, Japan.
Nephron. 2020;144 Suppl 1:86-90. doi: 10.1159/000512137. Epub 2020 Nov 30.
Living kidney donation improves the lives of individuals with kidney failure; however, recent studies have suggested that living kidney donors may be at a relatively higher risk of reduced renal function than healthy non-donors. We therefore aimed to evaluate the clinical and pathological findings in living kidney donors who developed kidney disease.
From January 1991 to May 2019, 1,625 live kidney donations were performed at our hospital. Among the donors, 7 developed kidney disease after donation and underwent open renal biopsy. We studied the clinical and pathological findings of these patients from their clinical records.
There were 3 patients with immunoglobulin A (IgA) nephropathy, 2 with membranous nephropathy, 1 with anti-neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis, and 1 with secondary focal segmental glomerulosclerosis (FSGS). All patients with IgA nephropathy had latent IgA deposition on their baseline biopsy. One patient with membranous nephropathy demonstrated findings of membranous nephropathy on the baseline biopsy, despite being asymptomatic. All patients, except for those with ANCA-associated nephropathy and secondary FSGS, recovered from the nephritis or maintained an adequate renal function after treatment.
DISCUSSION/CONCLUSION: Baseline biopsy is necessary for assessing the renal condition of kidney donors, and these donors require long-term follow-up based on their baseline biopsy findings. If donors develop kidney disease, appropriate diagnosis and treatment are essential.
活体肾捐献改善了肾衰竭患者的生活;然而,最近的研究表明,活体肾捐献者的肾功能下降风险可能相对高于健康的非捐献者。因此,我们旨在评估发生肾脏疾病的活体肾捐献者的临床和病理发现。
1991 年 1 月至 2019 年 5 月,我院共进行了 1625 例活体肾捐献。在这些捐献者中,有 7 人在捐献后出现肾脏疾病,并接受了开放性肾活检。我们从病历中研究了这些患者的临床和病理发现。
有 3 例为免疫球蛋白 A(IgA)肾病,2 例为膜性肾病,1 例为抗中性粒细胞胞质抗体(ANCA)相关性肾小球肾炎,1 例为继发性局灶节段性肾小球硬化症(FSGS)。所有 IgA 肾病患者的基线活检均有潜在的 IgA 沉积。1 例膜性肾病患者尽管无症状,但在基线活检时显示出膜性肾病的表现。除了 ANCA 相关性肾病和继发性 FSGS 患者外,所有患者的肾炎均已恢复或在治疗后维持了足够的肾功能。
讨论/结论:基线活检对于评估肾捐献者的肾脏状况是必要的,并且这些捐献者需要根据其基线活检结果进行长期随访。如果捐献者发生肾脏疾病,需要进行适当的诊断和治疗。