Abstract: TH-PO906
Safety of Low-Dose ACE Inhibition in Living Kidney Donors
Session Information
- Transplantation: Donation and Access
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Chaudhary, Ankur, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
- Yadav, Ashok Kumar, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
- Kumar, Vivek, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
- Kohli, Harbir Singh, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
- Kamboj, Kajal, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
Background
ACE inhibitor (ACEi) medications have positive effects on vascular function separate from their anti-hypertensive effects. We evaluated the safety of low dose ACEi, (Ramipril 1.25mg) in kidney donors and impact on flow mediated dilatation (FMD) at 6 months post donation.
Methods
In an open label, randomized control trial, all prospective living renal donors, 18-60 years, with no hypertension or allergy to ACEi were enrolled. Baseline eGFR and FMD were recorded, and subjects were randomized (1:) at the time of discharge to receive either daily dose of 1.25 mg of Ramipril or no medication. Repeat measurement of FMD and eGFR was done at 6 months after kidney donation. Subjects were withdrawn from the study during follow up if serum creatinine increased by >25% as compared to baseline, or serum potassium rose to >5.5 mEq/L, or systolic blood pressure (SBP) fell to <90 mm Hg or fell by >25% as compared to baseline.
Results
Total 59 subjects were enrolled and randomized. 29 and 30 participants were allocated to the Ramipril and Control arm respectively. At 6 month, 19 subjects in the intervention arm and 23 subjects in the control arm completed follow up(Figure 1). One participant in intervention arm developed side effect (increase in serum creatinine >25% from baseline). In the control arm, 2 subjects had a rise in serum creatinine. Mean difference in eGFR was 25.4±16.3ml/min/1.73m2 in intervention arm while 26.0±17.1ml/min/1.73m2 in the control arm (p=0.909). The mean difference in FMD at 6 months vs baseline in intervention arm was 3.63±10.76% while in control arm was -2.62±10.28% (p=0.098).
Conclusion
Use of ramipril in dose of 1.25 mg once every day in living kidney donors was safe. A trend in improvement in vascular function (increase in FMD) was noted in intervention arm suggesting further study the effect of ACEi on vascular function in post kidney donation with adequate sample size.
Patient flow
Funding
- Government Support – Non-U.S.