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Abstract: TH-OR59

Modifiable Risk Factors for New-Onset Hypertension After Live Kidney Donation

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Kim, Yaerim, Keimyung University School of Medicine, Daegu, Daegu, Korea (the Republic of)
  • Kang, Eunjeong, Ewha Women's University College of Medicine and Graduate School of Medicine, Seoul, Korea (the Republic of)
  • Park, Sehoon, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  • Kim, Yong Chul, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
  • Kim, Yon Su, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
  • Lee, Hajeong, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
Background

Hypertension is a common comorbidity and also a risk factor for the development of end-stage kidney disease in living kidney donors. Herein, we aimed to evaluate the impact of exposure to overweight after donation on the development of new-onset hypertension.

Methods

A total of 6,581 donors and 13,350 controls were extracted from the national health insurance database between 2001 and 2018. Subjects took national health check-up 2 times and more were included. Controls were randomly extracted after matching with age, sex, date of donation, underlying hypertension and diabetes in the general population. Exposure to overweight and obesity was defined by body mass index (BMI) ≥23 kg/m2 and ≥25 kg/m2 during follow-up period. Overweight/obesity status was divided into 4 groups; 1) persistently no exposure, 2) exposure at only last health check-up, 3) persistently exposure in two times of health check-up, and 4) recovered from exposure at last health check-up. We used a multivariate logistic regression model to identify risk factors for new-onset hypertension.

Results

A total of 1,642 donors and 3,655 controls were finally included in the study. During 7.3±3.2 years, there were 142 (8.6%) and 253 (6.9%) subjects newly diagnosed with hypertension, respectively. After adjusted such variables showed significance in univariate analysis, kidney donation significantly increased risk for the development of hypertension (adjusted odds ratio [aOR] 1.53, 95% confidence interval [CI] 1.21-1.93). Persistent overweight significantly increased risk for the development of hypertension (aOR 3.53, 95% CI 2.07-6.35 vs. aOR 1.69, 95% CI 1.19-2.43), whereas recovered from overweight did not increase risk (aOR 1.61, 95% CI 0.36-5.1 vs. aOR 0.87, 95% CI 0.35-1.87) in kidney donor and controls, respectively. Exposure to persistent obesity significantly increased the risk for hypertension in both groups, but recovered from obesity still increased the risk in kidney donors (aOR 2.51, 95% CI 1.03-5.45) in contrary to the control (aOR 1.60, 95% CI 0.88-2.76).

Conclusion

Both exposures to overweight or obesity increased the risk for new-onset hypertension, but recovered from overweight or obesity showed different results in donors. Physicians need to be focused on counseling for reducing the modifiable risk factor such as for overweight during the follow-up period.