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. 2009 Jan;20(1):181-8.
doi: 10.1681/ASN.2008030306. Epub 2008 Sep 24.

Glomerular function, structure, and number in renal allografts from older deceased donors

Jane C Tan  1 , Biruh Workeneh, Stephan Busque, Kristina Blouch, Geraldine Derby, Bryan D Myers
Affiliations

Glomerular function, structure, and number in renal allografts from older deceased donors

Jane C Tan et al. J Am Soc Nephrol. 2009 Jan.

Abstract

The 5-yr survival rate of renal allografts is significantly lower for grafts from older deceased donors than from younger deceased donors. For evaluation of the potential contribution of renal senescence in this shortened graft survival, glomerular function and structure were analyzed in allografts from deceased donors older than 55 yr ("aging") or younger than 40 yr ("youthful"). Aging donors had a significantly higher prevalence of sclerotic glomeruli (P < 0.002), and their nonsclerotic glomeruli tended to be larger, had a larger filtration surface area (P = 0.02), and had a higher single-nephron ultrafiltration coefficient (K(f); P = 0.07), suggesting a compensatory response to functional loss of glomeruli. After serum creatinine reached a stable nadir in the transplant recipients, GFR and its hemodynamic determinants were evaluated and the whole allograft K(f) was computed. Compared with the allografts from youthful donors, allografts from aging donors exhibited a 32% lower GFR, which was exclusively attributable to a 45% reduction in allograft K(f) (both P < 0.001). In addition, the number of functioning glomeruli per allograft was profoundly lower in grafts from aging donors than from youthful donors (3.6 +/- 2.1 x 10(5) versus 8.5 +/- 3.4 x 10(5); P < 0.01), and this could not be explained by the relatively modest 17% prevalence of global glomerulosclerosis in the aging group. The marked reduction in overall glomerular number in many aging donors may lead to a "remnant kidney" phenomenon, potentially explaining the shorter mean survival of these allografts.

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Figures

Figure 1.
Figure 1.
Allograft “optimal” GFR versus donor age, approximately 3 mo after Tx. The parallel dashed lines represent the normal range for GFR (10th to 90th percentiles) in healthy uninephric living donors.
Figure 2.
Figure 2.
NFG per allograft as a function of donor age assuming ΔP = 40 mmHg in each group. By linear regression, the inverse relationship is significant (R2 = 0.46, P < 0.01).
Figure 3.
Figure 3.
Box plots of NFG below and above age 55 yr estimated by stereologic methods (left) and in allograft recipients of youthful versus aging donors (Kf/SNKf; right). Estimation of NFG in aging donors were calculated assuming that ΔP = 40 mmHg (middle) or ΔP = 45 mmHg (right).
See this image and copyright information in PMC

References

    1. U.S. Transplantation Data, United Network for Organ Sharing (UNOS), 2008
    1. Davies DF, Shock NW: Age changes in glomerular filtration rate, effective renal plasma flow, and tubular excretory capacity in adult males. J Clin Invest 29: 496–507, 1950 - PMC - PubMed
    1. Hoang K, Tan JC, Derby G, Blouch KL, Masek M, Ma I, Lemley KV, Myers BD: Determinants of glomerular hypofiltration in aging humans. Kidney Int 64: 1417–1424, 2003 - PubMed
    1. Wesson LG: Renal hemodynamics in physiological states. In: Physiology of the Human Kidney, edited by Wesson LG, New York, Grune & Stratton, 1969, pp 96–108
    1. Lindeman RD: Overview: Renal physiology and pathophysiology of aging. Am J Kidney Dis 16: 275–282, 1990 - PubMed

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