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Quantitative and semi-quantitative histopathological examination of renal biopsies in healthy individuals, and associations with kidney function

Journal article
Authors Yael Bar
Lars Barregård
Gerd Sällsten
Maria Wallin
Johan Mölne
Published in Apmis
Volume 124
Issue 5
Pages 393-400
ISSN 0903-4641
Publication year 2016
Published at Institute of Biomedicine, Department of Pathology
Institute of Medicine, Department of Public Health and Community Medicine, Section of Occupational and environmental medicine
Pages 393-400
Language en
Links dx.doi.org/10.1111/apm.12520
Keywords Living donor, renal biopsy, kidney function, interstitial fibrosis and tubular atrophy, smoking, graft dysfunction, donor kidneys, clearance, inulin, adults, Immunology, Microbiology, Pathology
Subject categories Pathology, Microbiology in the medical area

Abstract

This study assesed the prevalence of histopathological changes in renal biopsies from healthy individuals, and the association with age, sex and smoking. Donor biopsies from 109 subjects were obtained from living kidney donors, and blood and urine samples were collected together with medical history. All biopsies were scored according to the Banff 97 classification with some modifications. The parameters included in this study were tubular atrophy, interstitial fibrosis, glomerulosclerosis, arteriosclerosis, arteriolohyalinosis and a sclerosis score. An alternative scoring system for tubular atrophy was examined (using 5% rather than <1% as a cut-off for grade 0). Glomerular filtration rate was measured in most cases as chromium ethylenediaminetetra-acetic acid (Cr-EDTA) clearance. Age was a significant predictor for tubular atrophy, fibrosis and sclerosis. Pack-years of smoking increased the risk of tubular atrophy, fibrosis and arteriolohyalinosis. The alternative scoring of tubular atrophy showed a stronger association with smoking, but a weaker association with age, compared with the original one. Limited histopathological changes are common in healthy kidney donors around 50 years of age with normal kidney function. We propose that a cut-off of 5% yields a better definition of grade 0 tubular atrophy compared with the established cut-off of >0%.

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