Prevalence, Mechanisms, Treatment, and Complications of Hypertension Postliving Kidney Donation.

Stuart Deoraj,Maria Irene Bellini,Dimitrios Anestis Moutzouris

doi:10.1155/2021/5460672

Abstract

Living kidney donors represent a unique population of patients. Potential donors are selected based on the belief that their preoperative fitness is likely to mitigate the risks of long- and short-term harm following uninephrectomy. Studies performed on postdonation outcomes have largely focused on mortality and the risk of end-stage renal failure, but have also investigated secondary outcomes such as cardiovascular morbidity and hypertension. It has been postulated that hypertension is a possible outcome of living kidney donation. A variety of studies have been conducted to investigate the prevalence, epidemiology, mechanisms, treatment strategies, and long-term ramifications of hypertension postdonation. These studies are heterogeneous in their population, design, methodology, and outcome measures and have presented contradicting outcomes. Additionally, the absence of a well-matched control group has made it challenging to interpret and generalise the reported findings. As such, it is not possible to definitively conclude that hypertension occurs at a higher rate among donors than the general population. This article will review the evidence of postdonation hypertension prevalence, mechanisms, treatment, and complications.

Highlights

Kidney transplantation, for the majority of patients with endstage renal failure, remains the treatment of choice of renal replacement therapy (RRT) [1] [2]
Regardless deceased donation currently accounts for over 60 percent of kidney transplantation occurring in both the United Kingdom and United States, alluding somewhat to the complexities and challenges associated with appropriate donor selection [5, 6]
A vast wealth of evidence exists on the long-term health complications associated with end-stage renal failure and dialysis, regarding the effects on patient-related qualitative outcomes and cardiovascular mortality which adjusts following kidney transplantation [7,8,9,10]

Summary

Introduction

For the majority of patients with endstage renal failure, remains the treatment of choice of renal replacement therapy (RRT) [1] [2]. Despite the dawn of complex, patient- and evidence-directed immunosuppressive treatment, compared with deceased kidney donation, living kidney donation is significantly associated with sustainably improved long-term physical, biochemical, and psychological outcomes of the recipients [3, 4]. A vast wealth of evidence exists on the long-term health complications associated with end-stage renal failure and dialysis, regarding the effects on patient-related qualitative outcomes and cardiovascular mortality which adjusts following kidney transplantation [7,8,9,10]. The volume of high-quality literature on long-term outcomes following an elective nephrectomy from an otherwise healthy donor is comparatively scanty. This review is aimed at assessing previous literature for evidence of the long-term sequelae in living kidney donation, focusing on the onset, epidemiology, prevalence, outcomes, and burden of hypertension following donor nephrectomy

Objectives

Methods

Findings

Conclusion