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Long-term kidney function and survival in recipients of allografts from living kidney donors with hypertension: a national cohort study. Transpl Int 2021 Aug;34(8):1530-1541

Date

06/16/2021

Pubmed ID

34129713

DOI

10.1111/tri.13947

Scopus ID

2-s2.0-85109388213 (requires institutional sign-in at Scopus site)   4 Citations

Abstract

Allografts from living kidney donors with hypertension may carry subclinical kidney disease from the donor to the recipient and, thus, lead to adverse recipient outcomes. We examined eGFR trajectories and all-cause allograft failure in recipients from donors with versus without hypertension, using mixed-linear and Cox regression models stratified by donor age. We studied a US cohort from 1/1/2005 to 6/30/2017; 49 990 recipients of allografts from younger (<50 years old) donors including 597 with donor hypertension and 21 130 recipients of allografts from older (≥50 years old) donors including 1441 with donor hypertension. Donor hypertension was defined as documented predonation use of antihypertensive therapy. Among recipients from younger donors with versus without hypertension, the annual eGFR decline was -1.03 versus -0.53 ml/min/m2 (P = 0.002); 13-year allograft survival was 49.7% vs. 59.0% (adjusted allograft failure hazard ratio [aHR] 1.23; 95% CI 1.05-1.43; P = 0.009). Among recipients from older donors with versus without hypertension, the annual eGFR decline was -0.67 versus -0.66 ml/min/m2 (P = 0.9); 13-year allograft survival was 48.6% versus 52.6% (aHR 1.05; 95% CI 0.94-1.17; P = 0.4). In secondary analyses, our inferences remained similar for risk of death-censored allograft failure and mortality. Hypertension in younger, but not older, living kidney donors is associated with worse recipient outcomes.

Author List

Al Ammary F, Yu S, Muzaale AD, Segev DL, Liyanage L, Crews DC, Brennan DC, El-Meanawy A, Alqahtani S, Atta MG, Levan ML, Caffo BS, Welling PA, Massie AB

Author

Ashraf El-Meanawy MD, PhD Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Allografts
Cohort Studies
Graft Survival
Humans
Hypertension
Kidney
Kidney Transplantation
Living Donors
Middle Aged
Retrospective Studies
Tissue Donors
Treatment Outcome