title: Pre-nephrectomy angiotensin II type 1 receptor antibodies in living kidney donors: A concern?
abstract: Angiotensin II type 1 receptor (AT1R) autoantibodies (AT1Rab) have been associated with pre-eclampsia and malignant hypertension. Overactivity of the angiotensin-II/AT1R complex has also been implicated in cardiac, renal, and vascular remodeling, leading to mortality and morbidity from cardiovascular disease. Pre-donation prevalence and possible post-donation effects of AT1Rab in living kidney donors (LKD) are unknown. In this study, sera obtained the day before nephrectomy and kept frozen at -70 degrees C from 113 strictly normotensive and non-obese LKD were tested for AT1Rab by OneLambda detection assay. AT1Rab titers >or=17 international units were considered positive. Pre-donation renal function [estimated glomerular filtration rate (eGFR)] and blood pressure at 1 and 12 months post-donation were recorded in every patient. Ten of 113 (8.8%) LKD yielded a positive AT1Rab result. History of sensitization events was similar in both groups. There was no difference in renal function between LKD with positive and negative AT1Rab results, 1 (mean eGFR 73.8 versus 72.4 mL/min/1.73m2) and 12 months post-donation (mean eGFR 74.1 versus 74.5 mL/min/1.73m2). During follow-up, none of the LKD developed hypertension (defined as blood pressure >130/85), nor did they require antihypertensive drugs. AT1Rab are apparently indolent in healthy adults after short-term follow-up. Longer observation of all LKD will be necessary to draw final conclusions.
authors.forename: Erick Alejandro
authors.initials: EA
authors.lastname: Hernández-Méndez
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Arreola-Guerra
authors.forename: Luis E
authors.initials: LE
authors.lastname: Morales-Buenrostro
authors.forename: Julia B
authors.initials: JB
authors.lastname: Ramírez
authors.forename: Said
authors.initials: S
authors.lastname: Calleja
authors.forename: Natalia
authors.initials: N
authors.lastname: Castelán
authors.forename: Isaac
authors.initials: I
authors.lastname: Salcedo
authors.forename: Mario
authors.initials: M
authors.lastname: Vilatobá
authors.forename: Alan G
authors.initials: AG
authors.lastname: Contreras
authors.forename: Bernardo
authors.initials: B
authors.lastname: Gabilondo
authors.forename: Julio
authors.initials: J
authors.lastname: Granados
authors.forename: Josefina
authors.initials: J
authors.lastname: Alberú
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000097:blood / Q000276:immunology*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D019520:Living Donors / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D057234:Preoperative Period; D011446:Prospective Studies; D044140:Receptor, Angiotensin, Type 1 / Q000276:immunology*; D012307:Risk Factors; D016036:Seroepidemiologic Studies
chemical_list: D001323:Autoantibodies; D044140:Receptor, Angiotensin, Type 1