Abstract: TH-PO134
Impact of Hypertension and White Coat Hypertension on Renal Function and Blood Pressure Post Kidney Donation
Session Information
- Transplantation: Cardiovascular and Metabolic Diseases
October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1802 Transplantation: Clinical
Authors
- Ratnayake, Aruni, Epsom and St Helier University Hospitals NHS Trust, London, United Kingdom
- Swift, Pauline A., Epsom and St Helier University Hospitals NHS Trust, London, United Kingdom
- Andrews, Peter A., Epsom and St Helier University Hospitals NHS Trust, London, United Kingdom
- Phanish, Mysore K., Epsom and St Helier University Hospitals NHS Trust, London, United Kingdom
Background
The effects of nephrectomy on blood pressure (BP) and renal function in kidney donors with hypertension (HTN) and white coat HTN are unclear. This study is a pilot of a planned larger project aimed at investigating this in UK kidney donor population.
Methods
Living donors with HTN and white-coat HTN (BP >140/90 but normal ABPM) between January 2010 to December 2014 were identified. Matched normotensive donors were chosen as controls.
Results
N=30, 10 in each category. Table 1 shows demographics pre-donation.
There was no significant difference in percentage reduction of eGFR post-donation across all donor groups (Figure 1).
No donor had proteinuria pre-donation. Post-donation, donors with normal BP and white coat HTN did not develop proteinuria. However 20% donors in HTN group developed proteinuria.
All normotensive donors had normal BP readings post-donation. No donors in the white coat HTN group took anti-hypertensive medication pre-donation; post-donation, 40% required medication. All donors in HTN group took anti-hypertensive medications pre-donation; of these, 70% had raised BP post-donation needing uptitration of medications.
Conclusion
There was no significant difference in change in renal function across all 3 groups. Our observations of higher incidence of proteinuria and uptitration of BP medications in donors with HTN, and significant proportion of donors with white coat HTN requiring antihypertensive medications post-donation merits further investigation. Our future work will investigate the impact of pre-donation HTN and white coat HTN on renal function and cardiovascular health in a large cohort of kidney donors.
| Normotension | White Coat HTN | HTN | |
| Age (years) - Median (Range) | 49 (32-64) | 47.5 (34-61) | 51 (45-66) |
| Gender | 60% male, 40% female | 50% male, 50% female | 40% male, 60% female |
| Ethnicity | 90% Caucasian, 10% Caribbean | 80% Caucasian, 10% African, 10% Other | 80% Caucasian, 20% Asian |
| eGFR (mls/min) - Median (Range) | 92 (72-114) | 95.5 (68-119) | 94.5 (64-103) |
| ACR (mg/g) | <5 | <5 | <5-16.1 |
| Clinic BP (mmHg) - Median (Range) | 128/79 (121/76-129/86) | 144/94 (124/76-162/104) | 145/88 (124/68-158/96) |
| Follow up time (months) - Median (Range) | 60 (48-84) | 54 (1-84) | 72 (36-96) |