{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T14:36:31Z","timestamp":1787236591572,"version":"build-2736575974"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Kidney donors with marginal characteristics, including those presenting with albuminuria, are increasingly being accepted to alleviate organ shortages in transplantation. However, high-quality evidence establishing the association between pre-donation donor albuminuria and graft survival remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective cohort study, we analyzed data from living-donor kidney transplants performed between 2017 and 2023. Donor-recipient pairs were stratified based on pre-donation urinary albumin-to-creatinine ratio (uACR) into High-uACR (uACR \u226530\u2005mg\/g) and Low-uACR (uACR &amp;lt;30\u2005mg\/g) groups, consistent with Kidney Disease: Improving Global Outcomes (KDIGO) criteria. The primary outcome was death-censored graft failure. Statistical analyses included Kaplan-Meier survival curves, multivariable Cox models, interaction and sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study included 1674 living-donor kidney transplantation pairs, comprising 120 in the High-uACR group and 1554 in the Low-uACR group. Recipients in the High-uACR group exhibited a higher incidence of death-censored graft failure compared with those in the Low-uACR group (14.17% [17\/120] vs. 2.19% [34\/1554]; P &amp;lt; .001). After full adjustment, the High-uACR group was associated with a 2.13-fold increased risk of death-censored graft failure (adjusted hazard ratio [HR] = 2.13, 95% confidence interval [CI] = 1.02\u20134.46, P = .044). Interaction analysis revealed that the risk was amplified among recipients whose donors had both elevated uACR and hypertension\/diabetes (HR = 4.73, 95% CI = 1.93\u201311.62, P = .001), compared to the reference group (Low-uACR donors without hypertension\/diabetes). This association remained consistent across subgroup analyses stratified by donor pre-donation estimated glomerular filtration rate ([eGFR] \u226590 or &amp;lt;90\u2005mL\/min\/1.73m2). Sensitivity analyses incorporating repeated uACR measurements, and competing risk analyses reported similar results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Elevated uACR in living donors had moderate predictive power for graft failure after kidney transplantation. Further studies should be conducted to explore the clinical utility of uACR within a comprehensive risk assessment framework to improve recipient risk stratification and support informed decision-making in donor selection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/joneph\/aajaf025","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T12:48:15Z","timestamp":1780663695000},"page":"733-741","source":"Crossref","is-referenced-by-count":0,"title":["Association between donor albuminuria and the risk of graft failure in living-donor kidney transplantation: a retrospective cohort study"],"prefix":"10.1093","volume":"39","author":[{"given":"Saifu","family":"Yin","sequence":"first","affiliation":[{"name":"Department of Urology\/Institute of Urology, West China Hospital, Sichuan University , Chengdu, Sichuan ,","place":["China"]},{"name":"Kidney Transplantation Center, West China Hospital, Sichuan University , Chengdu, Sichuan 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