Persistent, asymptomatic, microscopic hematuria in prospective kidney donors.
BACKGROUND
Asymptomatic, microscopic hematuria is seen in 8-21% of the general population, has a good prognosis, and is generally not an indication for kidney biopsy. But whether it should preclude kidney donation is unclear.


METHODS
Of 512 consecutive prospective donors, 14 (2.7%) continued to have asymptomatic, microscopic hematuria over 1 month. If the medical history, physical examination, and computerized tomographic angiography were unremarkable, and if they still wished to donate, a kidney biopsy was performed.


RESULTS
In two prospective donors, hematuria resolved after treatment for urinary tract infection; two others declined donation and were referred to their primary care provider. Kidney biopsy in the remaining 10 showed: two normal; four thin basement membrane nephropathy (TBMN); one nonhomogeneous basement membrane abnormalities; one IgA nephropathy, 5 of 16 glomeruli globally sclerotic; one in a patient with a family history of Schimke's Syndrome, 7 of 30 glomeruli globally sclerotic; and one TBMN and early hypertensive changes without systemic hypertension. Only 4 of the 10 who underwent kidney biopsy donated (two normal, two TBMN).


CONCLUSIONS
Kidney abnormalities are common in young, otherwise healthy, prospective kidney donor candidates with persistent, asymptomatic, microscopic hematuria. A kidney biopsy is often abnormal and aids in the decision-making process.
Koushik
Rahul
R
Departments of Medicine, Surgery, and Pathology, University of Minnesota, Minneapolis, MN 55455, USA. kidneycare@sbcglobal.net
Garvey
Catherine
C
Manivel
J Carlos
JC
Matas
Arthur J
AJ
Kasiske
Bertram L
BL
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D005260:Female; D050533:Glomerular Basement Membrane / Q000002:abnormalities; D005922:Glomerulonephritis, IGA / Q000652:urine; D006417:Hematuria / Q000175:diagnosis*; D006801:Humans; D007674:Kidney Diseases / Q000000981:diagnostic imaging / Q000473:pathology; D016030:Kidney Transplantation / Q000592:standards*; D019520:Living Donors; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed