{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:01:24Z","timestamp":1785456084904,"version":"3.56.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"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":[[2026,7,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The expansion of living donor criteria to address organ shortages includes considering donors with microalbuminuria, a biomarker of renal vulnerability. However, renal safety for these donors remains poorly defined. This study evaluated the medium-term kidney function trajectory of living kidney donors with pre-donation microalbuminuria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study analyzed consecutive living kidney donors from 2017 to 2023. Donors were stratified into Low-urine albumin-creatinine ratio (uACR) (uACR &amp;lt;30\u2005mg\/g) and High-uACR (uACR \u226530\u2005mg\/g) groups. Primary outcomes included post-nephrectomy kidney function and estimated glomerular filtration rate (eGFR) slope. We further used restricted cubic spline analyses to explore the non-linear dose-response relationship between pre-donation uACR and eGFR slope, and analyzed risk factors for steeper eGFR slope. Additionally, we performed hierarchical composite endpoint analyses via the Win Ratio method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 937 donors, 50 (5.3%) were included in the High-uACR group. After a median follow-up of approximately 30 months, no cases of kidney failure occurred. A significant post-donation increase in uACR was observed (43.4[range: 30.3\u201393.6; IQR: 35.9\u201371.9] vs. 56.5[range: 26.7\u2013106.3, IQR: 41.2\u201371.5] mg\/g, P &amp;lt; .001). The High-uACR group had a higher incidence of eGFR &amp;lt; 60\u2005mL\/min\/1.73\u2005m2 (8.0% vs. 1.8%, P = .018) and eGFR &amp;lt; 45\u2005mL\/min\/1.73\u2005m2 (4.0% vs. 0.6%, P = .049) compared with the Low-uACR group. The High-uACR group exhibited a steeper chronic eGFR slope (\u22121.7 vs. \u22120.5\u2005mL\/min\/1.73\u2005m2\/year, P &amp;lt; .001) but a similar acute eGFR slope (P = .524). Restricted cubic spline analyses revealed a non-linear relationship between pre-donation uACR and chronic eGFR slope (P &amp;lt; .001). Multivariable analyses confirmed that high pre-donation uACR was an independent risk factor for a steeper chronic eGFR slope (\u03b2 = \u22121.06\u2005mL\/min\/1.73\u2005m2\/year, P &amp;lt; .001). Consistent with these primary findings, hierarchical composite endpoint analysis demonstrated a statistical disadvantage for the High-uACR group (Win Odds: 2.27, 95% CI: 1.46\u20133.51, P &amp;lt; .001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pre-donation uACR \u2265 30\u2005mg\/g identifies living kidney donors at higher risk for adverse intermediate-term renal outcomes. Our results underscore the importance of uACR in donor evaluation, risk-stratified counseling, and intensified long-term follow-up for this vulnerable subgroup.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/joneph\/aajag060","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T12:38:28Z","timestamp":1773146308000},"page":"591-599","source":"Crossref","is-referenced-by-count":0,"title":["Association of pre-donation microalbuminuria with accelerated kidney function impairment in living kidney donors: 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 ,","place":["China"]},{"name":"Kidney Transplantation Center, West China Hospital, Sichuan University, Chengdu 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Laboratory Medicine, West China Hospital, Sichuan University, Chengdu ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2166-2217","authenticated-orcid":false,"given":"Tao","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Urology\/Institute of Urology, West China Hospital, Sichuan University, Chengdu ,","place":["China"]},{"name":"Kidney Transplantation Center, West China Hospital, Sichuan University, Chengdu ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"2026073019512377600_aajag060-B1","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1016\/S0140-6736(25)00239-9","article-title":"Scientific advances in the assessment, modification, and generation of transplantable organs for patients with end-stage organ 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