Mortality and ESRD in Older Live Kidney Donors with Hypertension

F. Al Ammary,¹ X. Luo,¹ A. Muzaale,¹ A. Massie,¹ D. Brennan,¹ A. Wiseman,² J. Snyder,³ D. Segev.¹

¹Johns Hopkins, Baltimore
²University of Colorado, Aurora
³SRTR, Minneapolis.

Meeting: 2018 American Transplant Congress

Abstract number: 332

Keywords: Donation, Hypertension, Kidney, Outcome

Session Information

Session Name: Concurrent Session: Kidney Living Donor: Long Term Outcomes

Session Type: Concurrent Session

Date: Monday, June 4, 2018

Session Time: 4:30pm-6:00pm

Presentation Time: 4:54pm-5:06pm

Location: Room 6A

Hypertension in otherwise healthy screened older kidney donor candidates is viewed as relatively benign, yet the long-term outcome of older donors with hypertension is unclear. We aimed to study the clinical significance of hypertension in older donors.

Methods: We analyzed SRTR data 1999-2015 to quantify the 15-year risk of mortality and ESRD in a cohort of 22,675 older (≥50y) kidney donors, including 2106 (9.3%) with hypertension, using Cox models adjusting for age, sex, race, eGFR, and recipient relationship.

Results: The study population median (IQR) age at donation was 56 (53–61) y, 60% were female, 88% were white, median (IQR) eGFR was 88.6 (78-98), 51% were biologically related to the recipient. Unadjusted 15-year mortality for donors with hypertension was comparable to those without hypertension (p=0.1; Figure, left panel). However, 15-year cumulative incidence of ESRD was substantially higher for donors with hypertension (86 per 10,000 vs. 26 per 10,000; p<0.001; Figure, right panel). These patterns of risk persisted after adjustment, aHR for mortality 1.10; 95%CI 0.77–1.59; p=0.6 and aHR for ESRD 2.7; 95%CI 1.15–6.49; p=0.02; Table).

Conclusion: Older donors with hypertension had an increased risk of ESRD, but the magnitude of absolute risk was small. Counseling of older donor-candidates with hypertension is warranted.

	Mortality		ESRD
Multivariable model	aHR (95%CI)	P-value	aHR (95%CI)	P-value
Hypertension	1.10 (0.77-1.59)	0.59	2.73 (1.15-6.49)	0.02
Age (per year)	1.10 (1.07-1.13)	<0.001	1.05 (0.97-1.14	0.22
Female	0.59 (0.45-0.77)	<0.001	0.56 (0.24-1.29)	0.17
Race (Ref=white) Black Hispanic	1.23 (0.73-2.07) 0.75 (0.40-1.38)	0.43 0.36	0.52 (0.07-4.01) 1.09 (0.25-4.72)	0.5 0.9
eGFR (per 10-unit increase)	0.94 (0.85-1.03)	0.22	1.13 (0.82-1.56)	0.44
Biologically related to recipient	1.06 (0.81-1.38)	0.67	1.58 (0.67-3.73)	0.29

CITATION INFORMATION: Al Ammary F., Luo X., Muzaale A., Massie A., Brennan D., Wiseman A., Snyder J., Segev D. Mortality and ESRD in Older Live Kidney Donors with Hypertension Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Ammary FAl, Luo X, Muzaale A, Massie A, Brennan D, Wiseman A, Snyder J, Segev D. Mortality and ESRD in Older Live Kidney Donors with Hypertension [abstract]. https://atcmeetingabstracts.com/abstract/mortality-and-esrd-in-older-live-kidney-donors-with-hypertension/. Accessed November 23, 2024.

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