HypertensionCohort study
Hypertension and Kidney Function After Living Kidney Donation
- Prospective cohort study
- inverse probability of treatment weighting on a propensity score
- 17 transplant centres (Canada, Australia)
Authors' conclusion
In this cohort study of living kidney donors and nondonors with the same follow-up schedule, the risks of hypertension and albuminuria were not significantly different. After the initial drop in eGFR from nephrectomy, donors had a slower mean rate of eGFR decline than nondonors but were more likely to have an eGFR between 30 and 60 mL/min/1.73 m2 at least once in follow-up.
Study context
- Population
- Normotensive adults donating a kidney and nondonors, 2004–2014, follow-up to November 2021weighted nondonors n = 928
- Participants
- 924 vs 396
- Exposure
- Living kidney donors vs nondonors
- Donorsn = 924
- Nondonorsn = 396reference
- Outcome
- Hypertension (SBP ≥140 mm Hg, DBP ≥90 mm Hg, or antihypertensive medication)
- Follow-up
- Median 7.3 years
Main finding
Hypertension · median 7.3 years (IQR, 6.0-9.0)
Weighted hazard ratio
1.11
95% CI 0.75–1.66
Events by group
Donors vs Nondonors
weighted HR 1.11 (95% CI 0.75–1.66)
As reported in the abstract
Observational data: associations, not effects.
Further findings
eGFR 30–60 mL/min/1.73 m² at least once
| Outcome | Donors | Nondonors | weighted HR (95% CI) | |
|---|---|---|---|---|
| Albuminuria | 15% | 11% | 1.46 (0.97–2.21) | |
| 0.512Weighted hazard ratio (log scale) |
| Outcome | Estimate |
|---|---|
| Annualized eGFR decline | lesser decline per year 1.4 mL/min/1.73 m² (95% CI 1.2–1.5) |
| Albuminuria | weighted between-group difference in albumin to creatinine ratio 1.02 (95% CI 0.88–1.19) |
- Annualized estimated glomerular filtration rate (eGFR) decline: after initial drop of mean 32 mL/min/1.73 m² after nephrectomy
- Albuminuria: donors n = 905, nondonors n = 904
Longitudinal change in mean BP
- Similar in donors and nondonors
Original publication
Hypertension and Kidney Function After Living Kidney Donation. JAMA. Published 23 July 2024. doi:10.1001/jama.2024.8523
Summarised from the published abstract; every number is checked against it