Systolic blood pressure must be monitored post-kidney donation in hypertensive patients
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Pre-donation hypertension was associated with a higher risk of uncontrolled post-donation systolic blood pressure among older kidney donors, according to findings presented at the American Transplant Congress.
“Programs have become more accepting of hypertensive older donors over time and have shown previously that older donors with hypertension experience a higher risk of end stage kidney disease,” Fawaz Al Ammary, MD, PhD, assistant professor at Johns Hopkins University School of Medicine, said. “We aimed to study systolic blood pressure (SBP) trajectory in older donors with vs. without pre-donated hypertension to assess the control of blood pressure post-donation.”
Using data from the Scientific Registry of Transplant Patients from 2010 to 2018, older kidney donors were evaluated for post-donation SBP in the first 2 years following nephrectomy. The association between hypertension and post donation SBP was modeled using a mixed linear model. Odds of having 6-month post-SBP were calculated using multivariable logistic regression as greater than 130 mmHg and greater than 140 mmHg.
Of 11,969 older kidney donors discovered, 9.7% presented with hypertension. Pre-donation SBP was calculated at 130 mmHg among hypertensive donors vs. 124 mmHg among non-hypertensive donors. Further analysis adjusted for pre-donation SBP showed hypertension was associated with a 2.4 mmHg increase in post-donation SBP with a 39% higher chance of greater than 130 mmHg 6-month post-SBP and a 50% higher chance of greater than 140 mmHg 6-month post-SBP.
“Our study implication is that we call for programs to monitor post-donation SBP in donors with hypertension to ensure adequate blood pressure control following donor nephrectomy,” Al Ammary concluded.
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Al Ammary F, et al. Poster #361. Presented at: American Transplant Congress; May 30-June 1, 2020. (virtual meeting).
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