Korean J Transplant.  2023 Nov;37(Suppl 1):S30. 10.4285/ATW2023.F-5977.

Comparisons of clinical outcomes between hypertensive and normotensive living kidney donors: a nationwide prospective cohort study

• Kim DK
• Lee YH
• Kim JS
• Jeong KH
• Chung KY
• Jeong JC
• Choi SJN
• Yang J
• Kim MS
• Hwang HS

• KMID: 2551604
• DOI: http://doi.org/10.4285/ATW2023.F-5977

Abstract

Background
Living kidney donors with hypertension is potential candidates to solve the imbalance between supply and demand for renal transplantation. However, the safety of hypertensive donors after donor nephrectomy is not sufficiently established.
Methods
We enrolled a total 642 hypertensive donors and 4,848 normotensive living kidney donors from the Korean Organ Transplantation Registry between 2014 and 2020. Primary outcome was the incident proteinuria and lower renal function, de-fined as an estimated glomerular filtration rate (eGFR) less than 60 or 45 mL/min/1.73 m ² .
Results
Hypertensive donors had lower eGFR before donation compared to normotensive donors, and this difference remained after transplantation. However, the risk of eGFR <60 mL/min/1.73 m ² (adjusted hazard ratio [HR], 0.87; 95% confidence interval [CI], 0.70–1.09; P=0.217) or <45 mL/min/1.73 m ² (adjusted HR, 1.52; 95% CI, 0.79–2.94; P=0.209) was not significantly increased in hypertensive donors after multiple adjustment. When comparing the rate of eGFR decline between the hypertensive and nor-motensive donors, there was no significant difference (adjusted unstandardized β, –0.19; –1.15 to 0.76; P=0.691). The incidence of proteinuria was higher in hypertensive donors, and they were found to have a significantly higher risk of proteinuria than normotensive donors (adjusted HR, 1.77; 95% CI, 1.10–2.85; P=0.020).
Conclusions
Our study indicates that the risk of proteinuria after donation was increased in hypertensive donors, while there is no significant decline in renal function. Careful monitoring for proteinuria is required in hypertensive donors after nephrectomy.