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Updated: Aug 18, 2025

Estimation of Nephron Number in Whole Kidney using the Acid Maceration Method
Published on: May 22, 2019
No difference in follow-up estimated glomerular filtration rate between hypertensive and matched nonhypertensive
Eun Hye Yang1, Sung Shin2, Young Hoon Kim2
1Division of Nephrology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
Insights
Kidney donors with controlled hypertension on 1-2 medications show similar long-term kidney function (eGFR) to non-hypertensive donors. This supports current guidelines for accepting hypertensive donors.
Area of Science:
- Nephrology
- Transplantation
- Cardiovascular Medicine
Background:
- Current guidelines permit kidney donors with controlled hypertension on 1-2 antihypertensive drugs.
- Previous studies initiated antihypertensive drug use post-donor registration, potentially indicating white-coat hypertension due to donation anxiety.
- This study investigates long-term outcomes in hypertensive kidney donors with pre-existing hypertension.
Purpose of the Study:
- To compare follow-up estimated glomerular filtration rate (eGFR) in kidney donors with pre-existing hypertension treated with 1-2 antihypertensive drugs versus matched non-hypertensive donors.
- To evaluate the safety and long-term renal function of living kidney donors with controlled hypertension.
Main Methods:
- A single-center retrospective study of 97 living hypertensive kidney donors.
- Hypertensive donors were categorized into two groups: those on 1 antihypertensive drug (61 donors) and those on 2 drugs (36 donors).
- Follow-up eGFR was compared between hypertensive donors and three matched non-hypertensive donors (matched for age, sex, follow-up duration).
Main Results:
- No significant difference in follow-up eGFR was observed between hypertensive donors (on 1 or 2 drugs) and their matched non-hypertensive controls at a mean follow-up of 51-54 months.
- The incidence of patients with follow-up eGFR < 45 mL/min/m² was similar between groups.
- Baseline eGFR was identified as the sole independent predictor of final follow-up eGFR in total donors.
Conclusions:
- The findings support current guidelines allowing kidney donor candidates with controlled hypertension (on 1-2 drugs) to donate.
- This study strengthens the recommendation for considering hypertensive individuals as kidney donors.
- Long-term renal function is preserved in hypertensive kidney donors with well-controlled blood pressure.
Background:
According to current guidelines, kidney donor candidates with controlled hypertension using 1 or 2 antihypertensive drugs may be considered as donor. However, this recommendation is based on the study that antihypertensive drug was initiated in mainly "after donor registration" and this may be white-coat hypertension because of donation-related anxiety. We compared the follow-up eGFR between kidney donors with preexisting hypertension and matched nonhypertensive donors.
Methods:
This single-center retrospective study classified 97 living hypertensive donors previously receiving antihypertensive drugs into two groups: 1 drug group (61 donors) and 2 drugs group (36 donors). We compared the follow-up eGFR between each donor previously receiving antihypertensive drugs and three matched nonhypertensive donors in terms of age, sex, and follow-up duration.
Results:
At a mean (range) of 51 months (12-214) in the 1 drug group, and 54 months (12-175) in the 2 drugs group after donation, there was no significant difference in follow-up eGFR between hypertensive donors previously receiving antihypertensive drugs and matched controls in each group and in total donors. There was no difference in the incidence of the patients with follow-up eGFR<45mL/min/m2 in each group and their matched controls. Multiple linear regression analysis showed that baseline eGFR was the only independent predictor for the final follow-up eGFR in the total donors.
Conclusion:
Our results support the current guidelines that donor candidates with controlled hypertension using 1 or 2 antihypertensive drugs may be considered as donors, and may increase the strength of this recommendation.
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