Long-term risk for kidney donors with hypertension at donation - a retrospective cohort study

Anders J Haugen1,2, Nina E Langberg1, Dag Olav Dahle1

  • 1Department of Transplant Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.

Insights

Hypertension in kidney donors does not appear to increase long-term mortality risk. This study suggests older kidney donors with high blood pressure may still be suitable candidates for donation.

Area of Science:

  • Nephrology
  • Cardiology
  • Transplantation

Background:

  • Elevated blood pressure (hypertension) is linked to increased mortality in the general population.
  • The long-term impact of hypertension on kidney donor mortality is less understood.
  • Kidney donation involves careful donor selection to ensure long-term health outcomes.

Purpose of the Study:

  • To evaluate the association between hypertension at the time of kidney donation and long-term overall and cardiovascular mortality.
  • To compare mortality rates in hypertensive kidney donors versus normotensive kidney donors.
  • To inform donor selection criteria regarding pre-existing hypertension.

Main Methods:

  • Retrospective analysis of 2131 kidney donors with available records.
  • Hypertension defined as blood pressure >140/90 mmHg or antihypertensive medication use.
  • Multivariable regression analyses to assess overall and cardiovascular mortality after a median follow-up of 20.8 years.

Main Results:

  • Hypertensive donors were older, more likely male, had higher BMI, and lower estimated glomerular filtration rate (eGFR).
  • Multivariable analysis showed no significant association between hypertension at donation and increased long-term overall mortality (HR 1.1, 95% CI 0.9-1.5).
  • No significant association was found between hypertension at donation and increased long-term cardiovascular mortality (HR 1.1, 95% CI 0.7-1.8).

Conclusions:

  • Hypertension at the time of kidney donation does not appear to be a contraindication for donation.
  • These findings may support the inclusion of older, otherwise healthy kidney donors with hypertension.
  • Further research could explore the impact of controlled hypertension on donor outcomes.

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