Kidney donor age of 50 years or above is a risk factor for calcineurin inhibitor‐induced nephrotoxicity

Abstract

AbstractIntroductionCalcineurin inhibitor (CNI)‐induced nephrotoxicity (CNI‐T) is a post‐transplantation complication that leads to graft dysfunction. Older‐donor kidney grafts may be susceptible to chronic CNI exposure because of long‐term arteriolar damage. The primary aim of this study was to examine the CNI‐T incidence and time‐course changes in the graft function according to donor age.MethodsWe included 334 kidney transplant recipients. CNI‐T was defined by Banff arteriolar hyaline thickening scores of ≥2 based on allograft protocol biopsy. Depending on donor age, participants were divided into the D > 70 (≥70 years), D60 (60–69 years), D50 (50–59 years), and D < 49: (≤49 years) groups. We investigated the extent to which CNI‐T affected the transplanted kidney function. Patients who did not develop CNI‐T during the study period were included in the non‐CNI‐T group; the remaining were grouped into the CNI‐T group.ResultsThe CNI‐T incidence was higher in donors aged >50 years. Compared to D < 49, the CNI‐T risk was 1.86 times higher in D50 and 2.9 times higher in D > 70. Furthermore, the CNI‐T group exhibited a significantly lower graft function 10 years after transplantation.ConclusionCNI‐T incidence increases in donors aged ≥50 years and affects renal function after 10 years.