{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T10:43:39Z","timestamp":1793357019286,"version":"4.5.0"},"reference-count":56,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA"],"published-print":{"date-parts":[[2024,7,23]]},"abstract":"\n Importance<\/jats:title>\n Recent guidelines call for better evidence on health outcomes after living kidney donation.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To determine the risk of hypertension in normotensive adults who donated a kidney compared with nondonors of similar baseline health. Their rates of estimated glomerular filtration rate (eGFR) decline and risk of albuminuria were also compared.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n Prospective cohort study of 924 standard-criteria living kidney donors enrolled before surgery and a concurrent sample of 396 nondonors. Recruitment occurred from 2004 to 2014 from 17 transplant centers (12 in Canada and 5 in Australia); follow-up occurred until November 2021. Donors and nondonors had the same annual schedule of follow-up assessments. Inverse probability of treatment weighting on a propensity score was used to balance donors and nondonors on baseline characteristics.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Living kidney donation.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Hypertension (systolic blood pressure [SBP] \u2265140 mm Hg, diastolic blood pressure [DBP] \u226590 mm Hg, or antihypertensive medication), annualized change in eGFR (starting 12 months after donation\/simulated donation date in nondonors), and albuminuria (albumin to creatinine ratio \u22653 mg\/mmol [\u226530 mg\/g]).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among the 924 donors, 66% were female; they had a mean age of 47 years and a mean eGFR of 100 mL\/min\/1.73 m\n 2<\/jats:sup>\n . Donors were more likely than nondonors to have a family history of kidney failure (464\/922 [50%] vs 89\/394 [23%], respectively). After statistical weighting, the sample of nondonors increased to 928 and baseline characteristics were similar between the 2 groups. During a median follow-up of 7.3 years (IQR, 6.0-9.0), in weighted analysis, hypertension occurred in 161 of 924 donors (17%) and 158 of 928 nondonors (17%) (weighted hazard ratio, 1.11 [95% CI, 0.75-1.66]). The longitudinal change in mean blood pressure was similar in donors and nondonors. After the initial drop in donors\u2019 eGFR after nephrectomy (mean, 32 mL\/min\/1.73 m\n 2<\/jats:sup>\n ), donors had a 1.4-mL\/min\/1.73 m\n 2<\/jats:sup>\n (95% CI, 1.2-1.5) per year lesser decline in eGFR than nondonors. However, more donors than nondonors had an eGFR between 30 and 60 mL\/min\/1.73 m\n 2<\/jats:sup>\n at least once in follow-up (438\/924 [47%] vs 49\/928 [5%]). Albuminuria occurred in 132 of 905 donors (15%) and 95 of 904 nondonors (11%) (weighted hazard ratio, 1.46 [95% CI, 0.97-2.21]); the weighted between-group difference in the albumin to creatinine ratio was 1.02 (95% CI, 0.88-1.19).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n \n In this cohort study of living kidney donors and nondonors with the same follow-up schedule, the risks of hypertension and albuminuria were not significantly different. After the initial drop in eGFR from nephrectomy, donors had a slower mean rate of eGFR decline than nondonors but were more likely to have an eGFR between 30 and 60 mL\/min\/1.73 m\n 2<\/jats:sup>\n at least once in follow-up.\n <\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier:\n NCT00936078<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jama.2024.8523","type":"journal-article","created":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T10:31:03Z","timestamp":1716460263000},"page":"287","source":"Crossref","is-referenced-by-count":48,"title":["Hypertension and Kidney Function After Living Kidney Donation"],"prefix":"10.1001","volume":"332","author":[{"given":"Amit X.","family":"Garg","sequence":"first","affiliation":[{"name":"Lawson Health Research Institute and London Health Sciences, London, Ontario, Canada"},{"name":"ICES, Ontario, Canada"},{"name":"Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada"},{"name":"Division of Nephrology, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada"},{"name":"Department of Research Methods, Evidence and Uptake, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer B.","family":"Arnold","sequence":"additional","affiliation":[{"name":"Lawson Health Research Institute and London Health Sciences, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meaghan S.","family":"Cuerden","sequence":"additional","affiliation":[{"name":"Lawson Health Research Institute and London Health Sciences, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Dipchand","sequence":"additional","affiliation":[{"name":"Department of Medicine (Nephrology), Queen Elizabeth II Health Sciences Centre and Dalhousie University Halifax, Nova Scotia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liane S.","family":"Feldman","sequence":"additional","affiliation":[{"name":"Department of Surgery, McGill University, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John S.","family":"Gill","sequence":"additional","affiliation":[{"name":"University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Karpinski","sequence":"additional","affiliation":[{"name":"University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Klarenbach","sequence":"additional","affiliation":[{"name":"University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg","family":"Knoll","sequence":"additional","affiliation":[{"name":"Department of Medicine (Nephrology), the Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charmaine E.","family":"Lok","sequence":"additional","affiliation":[{"name":"University Health Network, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Miller","sequence":"additional","affiliation":[{"name":"St Joseph\u2019s Healthcare, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauricio","family":"Monroy-Cuadros","sequence":"additional","affiliation":[{"name":"University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Nguan","sequence":"additional","affiliation":[{"name":"University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. 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Ramesh","family":"Prasad","sequence":"additional","affiliation":[{"name":"St Michael\u2019s Hospital, University of Toronto, Toronto, Ontario, Canada"},{"name":"University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica M.","family":"Sontrop","sequence":"additional","affiliation":[{"name":"Lawson Health Research Institute and London Health Sciences, London, Ontario, Canada"},{"name":"Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leroy","family":"Storsley","sequence":"additional","affiliation":[{"name":"University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Boudville","sequence":"additional","affiliation":[{"name":"Medical School, The University of Western Australia, Nedlands, Western Australia, 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