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medRxiv PreprintsInternational6 November 2026

A healthy donor kidney aging signature estimable from PAS histology and its association with progression of diabetic kidney disease

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Background. As kidneys age, their cells change in arrangement and gene expression. Whether these changes are also present in diabetic kidney disease (DKD), and whether they relate to how quickly kidney function is lost, is not known. Methods. Zero-time biopsies from 24 healthy living kidney donors (aged 36-66 years) and biopsies from 28 patients with DKD were profiled by single-cell-level spatial transcriptomics with a 5,101-gene panel. In the donors, we identified how cell neighborhoods and cell-type gene expression change with age and summarized the expression changes as tissue-aging scores.
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