title: Hyperechogenic renal parenchyma in potential live related kidney donors: Does it justify exclusion?
abstract: OBJECTIVE
  To assess the predictive importance of ultrasonic grade 1 hyperechogenicity in potential live related kidney donors in the absence of urinary abnormalities and with perfect renal function.
  
  
  METHODS
  The study included 34 potential living related kidney donors with this abnormality; their mean (SD, range) age was 32.7 (8.45, 23-48) years. Ten matched healthy donors with normal ultrasonographic appearance of the kidneys were studied as controls. All cases were thoroughly investigated, including measuring glomerular filtration rate by isotopic scintigraphy. The renal reserve was estimated by dopamine and amino-acid infusion in all subjects (study and control groups). A percutaneous renal biopsy was taken from 17 subjects in the abnormal echogenicity group and open renal biopsy was taken from eight of the control subjects.
  
  
  RESULTS
  The renal reserve was comparable in both groups. Abnormal histopathological changes were found in seven subjects (41%) of the abnormal echogenicity group, i.e. partial glomerulosclerosis in one, mesangial thickening in two, interstitial fibrosis in one, focal tubular atrophy in one, immunoglobulin (Ig M) immune deposits in three and IgA in one. Only one subject in the control group showed mild mesangial thickening.
  
  
  CONCLUSIONS
  Grade 1 echogenicity might be a sign of unrecognized kidney disease. Renal biopsy is mandatory when such related donors are the only available ones. Abnormal histopathology contraindicates donation.
authors.affiliation: Urology and Nephrology Centre, Mansoura University, Mansoura, Egypt.
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Fouda
authors.affiliation: Urology and Nephrology Centre, Mansoura University, Mansoura, Egypt.
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Shokeir
authors.affiliation: Urology and Nephrology Centre, Mansoura University, Mansoura, Egypt.
authors.forename: Ehab W
authors.initials: EW
authors.lastname: Wafa
authors.affiliation: Urology and Nephrology Centre, Mansoura University, Mansoura, Egypt.
authors.forename: Ayman F
authors.initials: AF
authors.lastname: Refaie
authors.affiliation: Urology and Nephrology Centre, Mansoura University, Mansoura, Egypt.
authors.forename: Tarek
authors.initials: T
authors.lastname: El Diasty
authors.affiliation: Urology and Nephrology Centre, Mansoura University, Mansoura, Egypt.
authors.forename: Mona
authors.initials: M
authors.lastname: Abdelrahim
authors.affiliation: Urology and Nephrology Centre, Mansoura University, Mansoura, Egypt.
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Sobh
authors.affiliation: Urology and Nephrology Centre, Mansoura University, Mansoura, Egypt.
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Ghoneim
keywords: Abnormality; IF, immunofluorescence; LM, light microscopy; Live-kidney donors; US, ultrasonography; Ultrasonography