P1676LONG TERM RENAL FUNCTIONS IN LIVING KIDNEY DONORS AND ITS RELATIONSHIP WITH TRANSFORMING GROWTH FACTOR ßETA-1GENE POLYMORPISMS. (6th June 2020)

• Record Type: Journal Article
• Authors: Tüzün, Betül Kübra; Helvacı, Özant; Yeter, Hasan Haci; ÖZBAŞ, BURAK; Korucu, Berfu; GÖNEN, Sevim; GÜZ, Galip
• Is Part Of: Nephrology dialysis transplantation. Volume 35(2020)Supplement 3
• Publication Date: 2020-06-06
• Subjects: Nephrology -- Periodicals; Hemodialysis -- Periodicals; Kidneys -- Transplantation -- Periodicals; Hemodialysis; Kidneys -- Transplantation; Nephrology; Periodicals; 616.61
• DOI: 10.1093/ndt/gfaa142.P1676
• Languages: English
• ISSNs: 0931-0509

Abstract

Abstract: Background and Aims: Renal transplantation is the optimal treatment choice for most patients with end-stage renal disease. Despite the efforts to increase cadaveric transplantation, the primary source of kidneys is still living donors. Donating a kidney is associated with lower than expected GFR especially in the presence of hypertension and proteinuria. Increased risk of ESRD and cardiovascular disease are small and controversial. TGF-β1 is an essential regulator of fibroblast phenotype and function, hence the main driver in most healthy/pathogenic fibrotic processes. TGF-β1 overexpression has been accused of poor results in chronic nephropathies. Single nucleotide polymorphisms (SNP) in the TGF-β1 gene may accelerate chronic allograft nephropathy and chronic kidney disease progression. In this study, we aimed to assess two TGF-β1 polymorphisms' effect on long term renal function in kidney donors. Method: This cross-sectional, single-center study was conducted in a tertiary referral center. Seventy-two living kidney donors who had donated between January 1999 and May 2018 were included in the study. The age, body mass index, and sex-matched control group consisted of 100 volunteers without systemic disease. GFR was calculated with CKD-EPI formula. Renal functions were compared between donors and controls. TGF-β1 gene polymorphism status of donors was evaluated with RT-PCR. Namely, +869T/C at codon 10 (rs1800470) and +915G/C at codon 25 (rs1800471) abbreviated as codon 10 SNP and 25 SNP respectively. TGF-β1 gene polymorphism effect on renal functions was assessed with a proper statistical approach. Results: The study included 72 (53 female, 19 male) kidney donors, and 100 (69 female, 31 male) healthy controls. The mean age of the donor group was 50 ± 12 years, and the mean age of the control group was 47 ± 11 years.The mean creatinine levels of donors were significantly higher than the mean creatinine levels of the control group (0.96±0.2 vs. 0.72±0.2 mg/dL p <0.001). The mean GFR values of donors were markedly lower than the GFR values of the control group (76±20 vs. 107±22 mL/min). Regarding codon 10 SNP status, 34/18/20 donors had C/C, T/C, and T/T phenotypes. The preoperative and final GFR were similar between all groups. Regarding codon 25 SNP status, 61/6/5 donors had G/G, G/C, and C/C phenotypes. The preoperative GFR was statistically similar between all groups. The final GFR was highest for donors with G/G phenotype and lowest for those with C/C phenotypes (Table1). Donors with C/C phenotype were at 4.7 fold increased risk for GFR< 60 ml/min compared to those with G/G phenotype (HR:4, 74 %95 CI: 1, 482-15, 212; p:0, 009). Conclusion: Kidney donation is associated with lower GFR compared to healthy individuals. The more profound decline in some cases may be explained with TGF-β1 SNP at codon 25. Our study shows C/C phenotype is associated with lower final GFR in renal transplant donors. We propose this particular finding might be useful for eligibility, especially for marginal donors after validation with studies including a higher number of participants.