Abstract: SA-PO1082
Effect of Prior Hypertensive Disorders of Pregnancy on Kidney Structure and Function in Kidney Donors
Session Information
- Transplantation: Clinical - Postkidney Transplant Outcomes and Potpourri
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Kattah, Andrea G., Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Rule, Andrew D., Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Mullan, Aidan F., Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Denic, Aleksandar, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Josephson, Michelle A., The University of Chicago, Chicago, Illinois, United States
- Garovic, Vesna D., Mayo Clinic Minnesota, Rochester, Minnesota, United States
Background
Hypertensive disorders of pregnancy (HDP) are associated with future chronic kidney disease (CKD). However, it is not clear whether a history of HDP should impact kidney donor acceptance.
Methods
Female kidney donors from 2000 to 2017 were sent a survey on pregnancy, including parity, history of HDP, gestational diabetes, and preterm delivery. At the time of donation, donors had measured GFR, 24h urine albumin, CT angiography of kidneys, and a kidney biopsy. Kidney volumes were calculated from CT images. Globally sclerosed glomeruli counts and % interstitial fibrosis/tubular atrophy (IFTA) were assessed via kidney biopsy. Kidney function and structural findings at the time of donation were assessed among parous women with a history of HDP vs. none, and among women with a history of any complication (HDP, gestational DM or preterm delivery) vs. none.
Results
There were 673 women who completed the survey and 74% had at least one pre-donation birth (n=498). Women with a history of HDP (n=45, 9.0%) were younger at the age of donation (mean (SD) 42.9 (9.0) vs. 49.6 (10.2) years, p<0.001) and had a higher BMI (29.4 (5.1) vs. 27.2 (4.8), p=0.003) than women with no HDP. After adjusting for age at donation, age at first pregnancy and parity, there were no significant differences in kidney volume, GFR, albuminuria or histology between women with HDP or no HDP, nor in women with any pregnancy complication vs. none (Table).
Conclusion
We conclude that prior HDP and pregnancy complications were not associated with structural or functional kidney changes. This is reassuring that prior HDP may not impact future kidney health in kidney donors that otherwise qualify for donation.
| Characteristic | Mean(SD) or n(%) | Mean(SD) or n(%) | ||||||
| Non-HDP (n=453) | HDP (n=45) | Adjusted percent diff | p-value | No complication (n=415) | Pregnancy complication (n=83) | Adjusted percent diff | p-value | |
| Total kidney volume, cm^3 | 265.3 (42.8) | 279.4 (35.6) | 3.1% (-1.6, 8.1%) | 0.19 | 265.1 (40.5) | 273.5 (50.0) | 2.0% (-1.6, 5.7%) | 0.28 |
| Total cortex volume, cm^3 | 184.5 (32.9) | 196.5 (27.1) | 3.5% (-1.7, 9.1%) | 0.18 | 184.7 (31.4) | 189.8 (37.3) | 1.2% (-2.7, 5.3%) | 0.54 |
| Total Medulla volume, cm^3 | 80.2 (18.5) | 81 (16.1) | 0.4% (-6.6, 8%) | 0.92 | 79.7 (17.4) | 83.3 (21.4) | 3.4% (-2.2, 9.2%) | 0.24 |
| Glomerular volume, mm^3 | 0.0024 (0.0009) | 0.0025 (0.0011) | 0.8% (-11.6, 15.0%) | 0.90 | 0.0024 (0.001) | 0.0024 (0.0009) | 0% (-9.4, 10.3%) | 0.99 |
| Cortex per glomerulus, mm^3 | 0.064 (0.032) | 0.079 (0.048) | 13.2% (-2, 30.7%) | 0.092 | 0.066 (0.035) | 0.063 (0.027) | -3.5% (-13.3, 7.5%) | 0.52 |
| Percent global glomerulosclerosis (%) | 4.6 (8.0) | 2.1 (3.8) | -14.4% (-38.7, 19.5%) | 0.36 | 4.6 (8.1) | 3.5 (5.9) | -3.2% (-24.5, 24.1%) | 0.80 |
| Percent IFTA, % | 0.3 (0.8) | 0.1 (0.3) | -9.3%(-39.8, 36.6%) | 0.64 | 0.3 (0.7) | 0.3 (1.1) | -12.9% (-35.7, 17.9%) | 0.37 |
| Measured GFR, ml/min/1.73 m^2 | 100.3 (19.3) | 105.6 (24.1) | 0.8% (-4.7, 6.6%) | 0.78 | 100.8 (20.0) | 100.7 (18.8) | -0.6% (-4.7, 3.7%) | 0.79 |
| 24 hour urine albumin, mg/24h | 5.6 (23.2) | 5.8 (7.7) | 25.9% (-7.7, 71.8%) | 0.15 | 6.2 (24.4) | 2.8 (5.3) | -18.3% (-34.8, 2.3%) | 0.079 |
| Nephron # per kidney, thousands | 1042.4 (409.9) | 1022.6 (446.6) | -7.9% (-18.9, 4.5%) | 0.20 | 1044.2 (418.9) | 1076.2 (384.2) | 4% (-5.4, 14.3%) | 0.42 |
| Singe nephron GFR, nl/min | 56.1 (20.4) | 65.7 (31.5) | 10.6% (-2.6, 25.5%) | 0.12 | 57.5 (22.4) | 53.9 (18.2) | -4.9% (-13.5, 4.5%) | 0.3 |
Adjusted for age at donation/pregnancy and parity