3. Urine dipstick showed a trace of blood on investigation of a potential female donor who is 31 years old. Urine microscopy confirmed microscopic haematuria (>5 RBCs/HPF), but no casts. No history of DM or hypertension. She has excellent kidney function with no evidence of proteinuria or microalbuminuria.

  • How do you proceed?
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Huda Al-Taee
Huda Al-Taee
2 years ago
  • How do you proceed?

31 years old female with isolated hematuria with excellent kidney function:
Reversible causes of hematuria need to be excluded as exercise, trauma, post-coital, and menstruation.
If no reversible cause can be found, we should look for other causes such as infection, stone, urological malignancies (unlikely at this age), and AV malformation.
If no specific cause is found and the hematuria is persistent, then a kidney biopsy needs to be considered to exclude GN like IgA, Alport syndrome, and TBMD.
Acceptance for donation will be according to the cause of hematuria:
For reversible causes: accept the donor.
For more serious conditions: cancel the donation.

References:

  1. Claisse G, Gaillard F, Mariat Ch. Living Kidney Donor Evaluation. Transplantation. 2020;104(12).
  2. KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors. Transplantation. 2017;101(8S).
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