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Updated: Dec 3, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Is the risk of cardiovascular disease increased in living kidney donors? A Danish population-based cohort study
Philip Munch1, Christian Fynbo Christiansen1, Henrik Birn2,3
1Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Insights
Living kidney donation may increase hypertension risk. However, this study found no increased risk of major adverse cardiovascular events (MACE), atrial fibrillation/flutter (AF), or death in kidney donors.
Area of Science:
- Nephrology
- Cardiology
- Public Health
Background:
- Reduced kidney function is a known risk factor for cardiovascular disease (CVD).
- The long-term cardiovascular risk for living kidney donors after nephrectomy is not well-established.
Purpose of the Study:
- To evaluate the risk of hypertension, atrial fibrillation/flutter (AF), major adverse cardiovascular events (MACE), and death in living kidney donors.
- To compare these risks against healthy individuals from the general population and a blood donor cohort.
Main Methods:
- Nationwide cohort study in Denmark from 1996 to 2018.
- Inclusion of 1,103 living kidney donors compared to a general population cohort and 1,007 compared to a blood donor cohort.
- Follow-up for a median of 8 years, assessing incident hypertension, AF, MACE (myocardial infarction, ischemic stroke, death), and all-cause mortality.
Main Results:
- Living kidney donors showed an increased risk of initiating hypertension treatment compared to blood donors (SIR, 1.40; 95% CI, 1.17-1.66).
- No increased risk of MACE was observed when compared to either the general population cohort (HR, 0.68; 95% CI, 0.52-0.89) or blood donors (SIR, 1.17; 95% CI, 0.88-1.55).
- There were no significantly increased risks of atrial fibrillation/flutter (AF) or death identified in kidney donors.
Conclusions:
- Living kidney donation is associated with a higher risk of developing hypertension.
- Despite the increased hypertension risk, living kidney donation does not appear to elevate the risk of major adverse cardiovascular events (MACE), AF, or mortality.
- Long-term cardiovascular health monitoring for kidney donors may be warranted, particularly for hypertension.
Abstract:
Reduced renal function is associated with cardiovascular disease (CVD); however, how living donor nephrectomy affects the risk of CVD remains controversial. We conducted a nationwide cohort study including living kidney donors in Denmark from 1996 to 2018 to assess the risk of hypertension, atrial fibrillation/flutter (AF), major adverse cardiovascular events (MACE; composite of myocardial infarction, ischemic stroke, and death) and death after living kidney donation. As comparisons we identified: a cohort of healthy individuals from the general population and an external blood donor cohort. We followed kidney donors (1,103 when compared with the general population cohort; 1,007 when compared with blood donors) for a median of 8 years. Kidney donors had an increased risk of initiating treatment for hypertension when compared with blood donors (standardized incidence ratio [SIR], 1.40; 95% confidence interval [CI], 1.17-1.66) but they did not have increased risk of MACE neither when compared with the general population cohort (hazard ratio, 0.68; 95% CI, 0.52-0.89) nor with blood donors (SIR, 1.17; 95% CI, 0.88-1.55). Neither did they have increased risks of AF and death. Thus, living kidney donation may be associated with increased risk of hypertension; however, we did not identify increased risks of CVD or death.
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