*Purpose: Among living kidney donors who develop hypertension (HTN), little is known about racial/ethnic differences in the relationship between physician trust levels and adherence to HTN treatment (e.g., healthy diet, physical exercise, and medication adherence).

*Methods: We conducted a retrospective cohort study among adults (aged 18 and older) who underwent live kidney donation at US-based transplant centers and developed HTN after donation. We ascertained data from patient medical records and phone surveys. We used validated Likert scales and multivariable logistic regression to assess potential racial/ethnic differences in treatment adherence by physician trust levels among living kidney donors diagnosed with HTN.

*Results: The study included 300 living donors who developed HTN after donation with 58% male, 81% White, 17% Black, and mean age 47.6 years. (Figure 1) Overall, 261 donors reported having higher levels of physician trust, and 41 donors reported lower levels of physician trust. There were no significant racial/ethnic differences in physician trust levels among living donors with HTN (p= 0.35). However, living kidney donors with higher levels of physician trust were significantly more likely than donors with lower levels of physician trust to report being adherent to their HTN treatment (aOR: 2.41, 95% CI: 1.10-5.27, p= 0.03). (Table 1)

*Conclusions: We found significant differences in hypertension treatment adherence by levels of physician trust among adult living kidney donors. This may be a potential target for improving long-term health outcomes among Black and White living kidney donors in the United States.

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