Hypertension, albuminuria risks are no worse for kidney donors than for non-donors: Study

Living kidney donors and non-donors have similar risks for hypertension and albuminuria, according to a study published online May 23 in the Journal of the American Medical Association (JAMA).

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 non-donors of similar baseline health in a prospective cohort study. The study included 924 standard-criteria living kidney donors and 928 non-donors after statistical weighting.

The researchers found that in a weighted analysis, hypertension occurred in 17% of donors and 17% of non-donors during a median follow-up of 7.3 years (weighted hazard ratio, 1.11; 95% confidence interval, 0.75 to 1.66). Donors and non-donors 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 non-donors. Compared with non-donors, more donors had an eGFR between 30 and 60 mL/minute/1.73 m² at least once during follow-up (47 versus 5%). Albuminuria occurred in 15 and 11% of donors and non-donors, respectively (weighted hazard ratio, 1.46; 95% 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.

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