TY - JOUR
T1 - Hypertension after kidney donation
T2 - Incidence, predictors, and correlates
AU - Sanchez, Otto A.
AU - Ferrara, Laine K.
AU - Rein, Sarah
AU - Berglund, Danielle
AU - Matas, Arthur J.
AU - Ibrahim, Hassan N.
N1 - Funding Information:
This study was supported by the National Institutes of Health (5P01
Funding Information:
This study was supported by the National Institutes of Health (5P01 DK013083).
Publisher Copyright:
© 2018 The American Society of Transplantation and the American Society of Transplant Surgeons
PY - 2018/10
Y1 - 2018/10
N2 - Incidence of postdonation hypertension, risk factors associated with its development, and impact of type of treatment received on renal outcomes were determined in 3700 kidney donors. Using Cox proportional hazard model, adjusted hazard ratios (HRs) for cardiovascular disease (CVD); estimated glomerular filtration rate (eGFR) <60, <45, <30 mL/min/1.73m2; end stage renal disease (ESRD); and death in hypertensive donors were determined. After a mean (standard deviation [SD]) of 16.6 (11.9) years of follow-up, 1126 (26.8%) donors developed hypertension and 894 with known antihypertensive medications. Hypertension developed in 4%, 10%, and 51% at 5, 10, and 40 years, respectively, and was associated with proteinuria, eGFR < 30, 45, and 60 mL/min/1.73m2, CVD, and death. Blood pressure was <140/90 mm Hg at last follow-up in 75% of hypertensive donors. Use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (compared to other antihypertensive agents) was associated with a lower risk for eGFR <45 mL/min/1.73m², HR 0.64 (95% confidence interval [CI] 0.45-0.9), P =.01, and also less ESRD; HR 0.03 (95% CI 0.001-0.20), P =.004. In this predominantly Caucasian cohort, hypertension is common after donation, well controlled in most donors, and factors associated with its development are similar to those in the general population.
AB - Incidence of postdonation hypertension, risk factors associated with its development, and impact of type of treatment received on renal outcomes were determined in 3700 kidney donors. Using Cox proportional hazard model, adjusted hazard ratios (HRs) for cardiovascular disease (CVD); estimated glomerular filtration rate (eGFR) <60, <45, <30 mL/min/1.73m2; end stage renal disease (ESRD); and death in hypertensive donors were determined. After a mean (standard deviation [SD]) of 16.6 (11.9) years of follow-up, 1126 (26.8%) donors developed hypertension and 894 with known antihypertensive medications. Hypertension developed in 4%, 10%, and 51% at 5, 10, and 40 years, respectively, and was associated with proteinuria, eGFR < 30, 45, and 60 mL/min/1.73m2, CVD, and death. Blood pressure was <140/90 mm Hg at last follow-up in 75% of hypertensive donors. Use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (compared to other antihypertensive agents) was associated with a lower risk for eGFR <45 mL/min/1.73m², HR 0.64 (95% confidence interval [CI] 0.45-0.9), P =.01, and also less ESRD; HR 0.03 (95% CI 0.001-0.20), P =.004. In this predominantly Caucasian cohort, hypertension is common after donation, well controlled in most donors, and factors associated with its development are similar to those in the general population.
KW - clinical research/practice
KW - donors and donation: donor follow-up
KW - epidemiology
KW - hypertension/antihypertensives
KW - kidney transplantation/nephrology
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U2 - 10.1111/ajt.14713
DO - 10.1111/ajt.14713
M3 - Article
C2 - 29498216
AN - SCOPUS:85044863943
VL - 18
SP - 2534
EP - 2543
JO - American Journal of Transplantation
JF - American Journal of Transplantation
SN - 1600-6135
IS - 10
ER -