Hypertension in Living Kidney Donors by Race/Ethnicity

By Victoria Socha - Last Updated: April 13, 2023

Complications associated with living kidney donation include hypertension. However, according to Ekamol Tantisattamo, MD, and colleagues, there are few data available on the level of risk for hypertension among living donors of different races.

The researchers conducted a retrospective cohort study using data from the Scientific Registry of Transplant Recipients (SRTR). Results were reported during a poster session at the National Kidney Foundation Spring Clinical Meetings 2023 in a poster titled Racial Disparity and Hypertension in Living Kidney Donors.

The SRTR includes living donors undergoing donation between June 1972 and September 2022. Multiple Cox proportional hazard regression analyses were used to examine time-to-event for developing postdonation systolic hypertension (SHTN). SHTN was defined as systolic blood pressure >130 mmHg.

Of the 174,359 living kidney donors, mean age was 41 years and 60% were female. Seventy percent were White, 11% were Black, 13% were Hispanic, 3% were Asian, 0.52% were American Indian/Alaska Native, 0.49% were multiracial, and 0.43% were Hawaiian/other Pacific Islander.

Up to 3.5% of the overall cohort had a history of hypertension prior to donation. The incidence rate of SHTN was 0.2 person-months. Compared with White donors, only Black donors had a significantly higher risk of developing SHTN (hazard ratio [HR], 1.05; 95% CI, 1.01-1.09). Other races/ethnicities had significantly lower risk; the Hawaiian/other Pacific Islander group had a nonsignificantly lower risk.

Following adjustment for age, sex, predonation obesity status, systolic blood pressure, diastolic blood pressure, pre- and postoperative serum creatinine, history of hypertension, and the interaction term between race/ethnicity and obesity status, the risk for developing SHTN remained increased in Black donors (HRBlack, 1.17; 95% CI, 1.06-1.28); Asian donors were at significantly lower risk (HRAsian, 0.85; 95% CI, 0.76-0.96). There were no significant differences in risk in other races/ethnic groups.

Obesity status was an effect modifier, with an attenuated risk for developing SHTN seen in Black donors with obesity (P for interaction, <.003).

In summary, the authors said, “Black [patients have] a persistently higher risk for developing postdonation hypertension compared to White [patients] independent of pre- and postdonation factors, while this outcome varies in other races/ethnicity. Preventive strategies for hypertension in living kidney donors should be implemented for pre- through postdonation periods.”

Source: Tantisattamo E, Hasjim B, Naunsilp P, Puchongmart C, Wattanachayakul P. Racial disparity and hypertension in living kidney donors. Poster #444. Abstract of a poster presented at the National Kidney Foundation Spring Clinical Meetings 2023; April 11-15, 2023; Austin, Texas.

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