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.
|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|
|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 October 20, 2020.
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