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Abstract: PO2075

The Association Between Pre-Donation Hypertension and Early Post-Donation Systolic Blood Pressure Among Older Living Kidney Donors

Session Information

Category: Hypertension and CVD

  • 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention

Authors

  • Al Ammary, Fawaz, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Muzaale, Abimereki, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Brennan, Daniel C., Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Segev, Dorry L., Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Massie, Allan, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
Background

One mechanism underlying predonation hypertension in older (age≥50) living kidney donors is a reduced number of nephrons. The 50% nephron mass reduction associated with donor nephrectomy may exacerbate predonation, controlled hypertension. In light of evolving hypertension guidelines, we aimed to study systolic blood pressure (BP) trajectory in older donors with- vs. without hypertension.

Methods

We conducted a national registry study of 11,969 older living kidney donors from 2010-2018. We modeled the association between predonation hypertension and postdonation systolic BP using a mixed linear model with donor-level random intercept adjusting for age, sex, race, predonation systolic BP, BMI, and year of donation. We modeled odds of having 6-month postdonation systolic BP >130 mmHg and >140 mmHg using multivariable logistic regression.

Results

1,161 of 11,969 older donors (9.7%) had hypertension. Median (IQR) predonation systolic BP was 130 mmHg (122-140) among donors with hypertension vs. 124 mmHg (115-132) among those without (p<0.001). After adjustment for baseline characteristics including predonation systokic BP, hypertension was associated with a 1.82.43.0 mmHg increase in postdonation systolic BP (p<0.001). Hypertension was associated with 39% higher odds of having 6-month postdonation systolic BP >130 mmHg (aOR=1.201.391.61, p<0.001) and 50% higher odds of having 6-month postdonation systolic BP >140 mmHg (aOR=1.251.501.82, p<0.001).

Conclusion

Predonation hypertension was associated with higher risk of uncontrolled 6-month postdonation systolic BP among older donors, even after adjusting for predonation systolic BP. Our findings call for programs to monitor postdonation systolic BP in donors with hypertension to ensure adequate BP control following nephrectomy.

Postdonation Systolic BP Trajectories in Older Donors with vs. without Predonation Hypertension

Funding

  • NIDDK Support