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Living kidney donors and nondonors have similar risks for hypertension and albuminuria, according to a study published online May 23 in the Journal of the American Medical Association.
Amit X. Garg, M.D., Ph.D., from the Lawson Health Research Institute and London Health Sciences in Ontario, Canada, and colleagues examined the risk for hypertension in normotensive adults who donated a kidney versus nondonors of similar baseline health in a prospective cohort study. The study included 924 standard-criteria living kidney donors and 928 nondonors after statistical weighting.
The researchers found that in a weighted analysis, hypertension occurred in 17 percent of donors and 17 percent of nondonors during a median follow-up of 7.3 years (weighted hazard ratio, 1.11; 95 percent confidence interval, 0.75 to 1.66). Donors and nondonors had a similar longitudinal change in mean blood pressure. Donors had an initial drop in estimated glomerular filtration rate (eGFR) after nephrectomy, followed by a 1.4-mL/minute/1.73 m2 per year lesser decline in eGFR than nondonors. Compared with nondonors, more donors had an eGFR between 30 and 60 mL/minute/1.73 m2 at least once during follow-up (47 versus 5 percent). Albuminuria occurred in 15 and 11 percent of donors and nondonors, respectively (weighted hazard ratio, 1.46; 95 percent confidence interval, 0.97 to 2.21).
“Ultimately, their study findings provide some reassurance, particularly the demonstration that donor nephrectomy did not have adverse effects on blood pressure or eGFR trajectories,” Elizabeth C. Lorenz, M.D., and Wolfgang C. Winkelmayer, M.D., M.P.H., Sc.D., both from Baylor College of Medicine in Houston, write in an accompanying editorial.
One author disclosed ties to Alexion and Astellas.
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