Predonation Hypertension and Early Postdonation Systolic Blood Pressure among Older Living Kidney Donors

F. Al Ammary¹, A. D. Muzaale², D. C. Brennan¹, D. L. Segev², A. B. Massie²

¹Medicine, Johns Hopkins University, Baltimore, MD, ²Surgery, Johns Hopkins University, Baltimore, MD

Meeting: 2020 American Transplant Congress

Abstract number: 361

Keywords: Hypertension, Kidney, Living donor, Outcome

Session Information

Session Name: Kidney Living Donor: Long Term Outcomes

Session Type: Oral Abstract Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:45pm

Presentation Time: 4:27pm-4:39pm

Location: Virtual

*Purpose: One mechanism underlying predonation hypertension in older (age≥50) living kidney donors is a reduced number of nephrons. The 50% nephron mass reduction associated with donor nephrectomy may exacerbate predonation, controlled hypertension. In light of evolving hypertension guidelines, we aimed to study systolic blood pressure (SBP) trajectory in older donors with- vs. without hypertension.

*Methods: Using SRTR data, we studied postdonation SBP (post-SBP) in the first two years following nephrectomy among 11,969 older living kidney donors from 2010-2018. We modeled the association between hypertension and post-SBP using a mixed linear model with donor-level random intercept adjusting for age/sex/race, predonation SBP, BMI, and year of donation. We modeled odds of having 6-month post-SBP >130 mmHg and >140 mmHg using multivariable logistic regression.

*Results: 1,161 of 11,969 older donors (9.7%) had hypertension. Median (IQR) predonation SBP was 130 mmHg (122-140) among donors with hypertension vs. 124 mmHg (115-132) among those without (p<0.001). After adjustment for baseline characteristics including predonation SBP, hypertension was associated with a _1.82.4_3.0 mmHg increase in post-SBP (p<0.001). Hypertension was associated with 39% higher odds of having 6-month post-SBP >130 mmHg (aOR=_1.201.39_1.61, p<0.001) and 50% higher odds of having 6-month post-SBP >140 mmHg (aOR=_1.251.50_1.82, p<0.001).

*Conclusions: Predonation hypertension was associated with higher risk of uncontrolled 6-month post-SBP among older donors, even after adjusting for predonation SBP. Our findings call for programs to monitor post-SBP in donors with hypertension to ensure adequate blood pressure control following nephrectomy.

To cite this abstract in AMA style:

Ammary FAl, Muzaale AD, Brennan DC, Segev DL, Massie AB. Predonation Hypertension and Early Postdonation Systolic Blood Pressure among Older Living Kidney Donors [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/predonation-hypertension-and-early-postdonation-systolic-blood-pressure-among-older-living-kidney-donors/. Accessed November 24, 2024.

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