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Blood pressure and renal function after kidney donation from hypertensive living donors

Stephen C Textor1, Sandra J Taler, Nancy Driscoll

  • 1Department of Medicine, Divisions of Nephrology and Hypertension, W9A, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. textor.stephen@mayo.edu

Transplantation
|July 29, 2004
PubMed

Insights

Selected hypertensive patients with normal kidney function can safely donate kidneys. This study found no adverse effects on blood pressure, kidney function, or urine protein in hypertensive donors one year post-donation.

Area of Science:

  • Nephrology
  • Transplant Surgery
  • Hypertension Management

Background:

  • Increasing end-stage kidney disease necessitates expanding the living kidney donor pool.
  • Essential hypertension is a common comorbidity, previously limiting donor eligibility.
  • This study investigated the safety of accepting donors with controlled hypertension.

Purpose of the Study:

  • To evaluate the outcomes of living kidney donors with essential hypertension.
  • To assess blood pressure, kidney function, and urinary protein excretion one year post-nephrectomy.
  • To determine the safety of including selected hypertensive individuals in living kidney donation programs.

Main Methods:

  • Prospective study of 148 living kidney donors, including 24 with pre-existing hypertension.
  • Detailed measurements of blood pressure (clinic, nurse, and ambulatory), glomerular filtration rate (GFR), and urine protein.
  • Assessment of renal and clinical characteristics before and 6-12 months after nephrectomy.

Main Results:

  • Hypertensive donors experienced a significant reduction in blood pressure post-donation with treatment.
  • Hypertensive donors were older and had a slightly lower GFR post-donation compared to normotensive donors.
  • No significant changes in urine protein or microalbumin were observed in either group.

Conclusions:

  • White individuals with moderate essential hypertension and normal kidney function show no adverse outcomes one year after kidney donation.
  • Selected hypertensive donors demonstrate acceptable safety profiles regarding blood pressure, GFR, and urinary protein.
  • Further long-term studies are warranted, but current data support considering selected hypertensive patients for living kidney donation.
Abstract

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