Living Kidney Donors at Higher Risk of Developing Hypertension

Living kidney donors are more prone to developing hypertension than non-donors. Controlling high blood pressure is important for kidney donors to reduce the risk of complications, such as kidney failure.

Highlights:

Living kidney donors have a higher risk of developing hypertension than non-donors
It is very important for kidney donors to control their blood pressure
This will avoid complications such as reduced kidney function and subsequent kidney failure

Living kidney donors are at a higher risk of developing hypertension, compared to non-donors, reveals a new study conducted by physicians at the Johns Hopkins University. Since hypertension can have deleterious effects on kidney function, it should be controlled in individuals who are kidney donors.

The study, published in the Clinical Journal of the American Society of Nephrology (CJASN), was led by Dr. Dorry L. Segev, MD, PhD, who is the Marjory K. and Thomas Pozefsky Professor of Surgery and Epidemiology, the Associate Vice-Chair in the Department of Surgery and the Founder and Director of the Epidemiology Research Group in Organ Transplantation (ERGOT) at Johns Hopkins University, Baltimore, MD, USA.

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‘Living kidney donors are more likely to develop hypertension than non-donors. High blood pressure must be controlled in kidney donors to reduce the risk of complications such as kidney failure.’
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Key Features of the Study

The main features of the study are highlighted below:

1,295 living kidney donors and 8,233 healthy non-donors were included in the study
The two groups were compared to establish whether living kidney donation was linked to a higher risk of hypertension and subsequent kidney failure
Prevalence hypertension in participants of different races at the 15-year mark are indicated below:

8 percent of White non-donors developed hypertension
9 percent of Black non-donors developed hypertension
23 percent of White donors developed hypertension
42 percent of Black donors developed hypertension

Kidney donation was linked to a 19 percent higher risk of developing hypertension after 6 years of follow-up
Association between kidney donation and hypertension didn’t vary with race
Kidney function deteriorated over time in White and Black non-donors, which fell sharply if hypertension developed
Kidney function improved over time in White and Black kidney donors, which reached a plateau if hypertension developed

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Age alone is not a contraindication to kidney donation. Kidney donation among carefully selected 60‐years‐old and older adults poses minimal perioperative risks and no added risk of long‐term end‐stage renal disease (ESRD).

Implications of the Study – Expert Opinion

The paper was accompanied by an editorial entitled: Is hypertension following donor nephrectomy cause for elevated living donor kidney function concern? The editorial was written by Dr. William S. Asch, MD, PhD, who is an Associate Professor Term and Director of Pre-Transplant Operations at Yale University School of Medicine, New Haven, CT, USA. He indicated: “The study findings have the potential to shift the public and media’s perception of the safety of living kidney donation especially when coupled with the earlier reports already indicating an increased risk of end stage renal disease (ESRD) in living donors.”

Hypertension May Pose Health Risks to Older Kidney Donors
Older living kidney donors with hypertension have a higher risk of developing kidney failure across 15 years after donation. However, those with hypertension are not at risk of dying early.

Concluding Remarks

The authors of the paper concluded: “Further work is needed to identify opportunities and best practices for preventing, recognizing, and managing hypertension in living kidney donors.”

Reference:

Self-Reported Incident Hypertension and Long-Term Kidney Function in Living Kidney Donors Compared with Healthy Non-donors - (https://doi.org/10.2215/CJN.04020419)

Source-Medindia

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