Self-Reported Incident Hypertension and Long-Term Kidney Function in Living Kidney Donors Compared with Healthy Nondonors
Self-Reported Incident Hypertension and Long-Term Kidney Function in Living Kidney Donors Compared with Healthy Nondonors
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DOI：
10.2215/cjn.04020419
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发表时间：
2019-10-07
影响因子：
9.8
通讯作者：
Massie, Allan B.
中科院分区：
文献类型：
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作者：
Holscher, Courtenay M.;Haugen, Christine E.;Massie, Allan B.
背景和目的活体肾脏捐献导致高血压的风险以及移植后高血压对随后的EGFR的影响尚不清楚。我们试图通过比较活体肾脏捐赠者和健康非捐赠者的队列来了解活体肾脏捐赠、高血压和长期EGFR之间的关系。设计、设置、参与者和测量我们比较了1295名活体肾脏捐赠者和8233名健康非捐赠者的加权队列，他们的平均随访时间为6年。我们使用参数生存模型量化了自我报告高血压的风险。结果肾脏捐献与高血压风险增加19%的独立关联(调整后的危险比为1.19；95%可信区间为1.01至1.41；P=0.04)；这种关联不受种族的影响(交互作用P=0.60)。对于白人和黑人非献血者，EGFR平均下降(分别为-0.4和-0.3ml/min/年)，并在高血压事件后急剧下降(分别为-0.8和-0.9ml/min/年；均P
Background and objectives The risk of hypertension attributable to living kidney donation remains unknown as does the effect of developing postdonation hypertension on subsequent eGFR. We sought to understand the association between living kidney donation, hypertension, and long-term eGFR by comparing donors with a cohort of healthy nondonors.Design, setting, participants, & measurements We compared 1295 living kidney donors with median 6 years of follow-up with a weighted cohort of 8233 healthy nondonors. We quantified the risk of self-reported hypertension using a parametric survival model. We examined the association of hypertension with yearly change in eGFR using multilevel linear regression and clustering by participant, with an interaction term for race.Results Kidney donation was independently associated with a 19% higher risk of hypertension (adjusted hazard ratio, 1.19; 95% confidence interval, 1.01 to 1.41; P=0.04); this association did not vary by race (interaction P=0.60). For white and black nondonors, there was a mean decline in eGFR (-0.4 and -0.3 ml/min per year, respectively) that steepened after incident hypertension (-0.8 and -0.9 ml/min per year, respectively; both P