Onset of Hypertension in Living Kidney Donors After Donor Nephrectomy: Our 20 Years of Experience.

OBJECTIVES: The development of hypertension can negatively affect cardiovascular and renal outcomes in renal kidney donors. Here, we retrospectively investigated the frequency and risk factors of hypertension development in healthy renal donors at our center.

MATERIALS AND METHODS: Living donors of kidney transplants performed between January 1998 and December 2016 were evaluated. Those > 18 years old, having glomerular filtration rate > 70 mL/min/1.72 m², body mass index ≤ 35 kg/m², and proteinuria < 300 mg/day were eligible. Those with a history of diabetes and hypertension and < 1 year of follow-up were excluded.

RESULTS: In the 190 included donors, mean follow-up was 56 ± 45 months, mean age was 47 ± 10 years, and 48% were women. Baseline systolic and diastolic blood pressures were 118 ± 13 and 76 ± 8.8 mm Hg. Follow-up showed that 19 donors (10%) developed hypertension. These donors were older and had higher baseline systolic blood pressure (126 ± 13 vs 117 ± 12 mm Hg; P = .003), proteinuria (162 ± 89 vs 117 ± 63 mg/day; P = .05), fasting blood glucose (99 ± 10 vs 94 ± 9.6 mg/dL; P = .03), and uric acid levels (5.4 ± 1.7 vs 4.5 ± 1.2 mg/dL; P = .04). Although these donors had baseline glomerular filtration rates (97 ± 22 vs 104 ± 22 mL/min/1.72 m²; P = .19) similar to other donors, levels were lower at last follow-up (62 ± 14 vs 71 ± 19 mL/min/1.72 m²; P= .03). In multiple regression analysis, preoperative fasting blood glucose, systolic blood pressure, and serum uric acid levels independently predicted hypertension development.

CONCLUSIONS: In healthy renal donors, preoperative detailed evaluations can provide important information foreseeing the development of hypertension after nephrectomy.