Older Kidney Donors With HTN at Higher Risk for ESKD Later
But absolute risk is small; hypertension not linked to higher risk for early death among older donors
WEDNESDAY, June 26, 2019 (HealthDay News) -- Older kidney donors with hypertension have an increased risk for end-stage kidney disease (ESKD), but not mortality, through 15 years after donation, according to a study published online June 25 in the Clinical Journal of the American Society of Nephrology.
Fawaz Al Ammary, M.D., Ph.D., from Johns Hopkins University in Baltimore, Maryland, and colleagues linked a U.S. cohort of 24,533 older donors from 1999 to 2016, including 2,265 with predonation hypertension, to the Centers for Medicare & Medicaid Services data and the Social Security Death Master File. Development of ESKD and mortality was ascertained during a median follow-up of 7.1 years.
The researchers found that during the study period, there were 24 ESKD and 252 death events. The 15-year risk for ESKD was 0.8 and 0.2 percent for donors with and without hypertension, respectively (adjusted hazard ratio, 3.04; 95 percent confidence interval, 1.28 to 7.22; P = 0.01). The risk for ESKD was 6.21-fold higher (95 percent confidence interval, 1.20 to 32.17; P = 0.03) for donors using antihypertensive therapy versus those not using antihypertensive therapy in the years when predonation use of antihypertensive therapy was available. No significant correlation was seen between donor hypertension and 15-year mortality (hazard ratio, 1.18; 95 percent confidence interval, 0.84 to 1.66; P = 0.34).
"These findings may inform conversations between the provider and the older individuals with hypertension when they consider donating a kidney," Al Ammary said in a statement.