The association of predonation hypertension with glomerular function and number in older living kidney donors

Area of Science:

• Nephrology
• Transplantation Science
• Hypertension Research

Background:

• The impact of pre-existing hypertension on kidney donor nephron count is not well-understood.
• Living kidney donation involves physiological and anatomical changes in the remaining kidney.

Purpose of the Study:

• To determine the association between pre-donation hypertension and glomerular number and volume in living kidney donors.
• To assess the effects of pre-donation hypertension on post-donation blood pressure, hyperfiltration, and compensatory glomerular hypertrophy.

Main Methods:

• Physiologic, morphometric, and radiologic evaluations were performed on 51 living kidney donors before and after donation.
• Number of functioning glomeruli (NFG) was estimated by dividing the whole-kidney ultrafiltration coefficient (Kf) by the single-nephron ultrafiltration coefficient (SNKf).
• Comparison between hypertensive and normotensive donors was conducted using age- and sex-matched groups.

Main Results:

• Pre-existing hypertension was associated with reduced NFG in donors older than 50 years.
• Hypertensive donors exhibited significantly lower NFG (359,499±128,929) compared to normotensive donors (558,239±205,152).
• Glomerulopenia in hypertensive donors was linked to a non-significant decrease in GFR, with no observed differences in post-donation blood pressure, hyperfiltration, or hypertrophy.

Conclusions:

• Living kidney donors with pre-existing hypertension, particularly older individuals, may have a reduced number of functioning glomeruli.
• The findings suggest a need for long-term monitoring of living kidney donors with pre-existing hypertension due to potential glomerulopenia.
• Further research is warranted to understand the long-term implications of hypertension-associated glomerulopenia in kidney donors.