{"id":26116,"date":"2024-07-25T04:01:00","date_gmt":"2024-07-24T20:01:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=26116"},"modified":"2024-07-26T04:55:37","modified_gmt":"2024-07-25T20:55:37","slug":"jama%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e6%8d%90%e7%8c%ae%e8%82%be%e8%84%8f%e5%90%8e%e7%9a%84%e9%ab%98%e8%a1%80%e5%8e%8b%e5%92%8c%e8%82%be%e8%84%8f%e5%8a%9f%e8%83%bd","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=26116","title":{"rendered":"[JAMA\u53d1\u8868\u8bba\u6587]\uff1a\u6350\u732e\u80be\u810f\u540e\u7684\u9ad8\u8840\u538b\u548c\u80be\u810f\u529f\u80fd"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

May 23, 2024<\/p>\n\n\n\n

Hypertension and Kidney Function After Living Kidney Donation<\/h1>\n\n\n\n

Amit X. Garg, Jennifer B. Arnold, Meaghan S. Cuerden, et al<\/h3>\n\n\n\n

JAMA. <\/em>Published online May 23, 2024. doi:10.1001\/jama.2024.8523<\/h3>\n\n\n\n

Key Points<\/p>\n\n\n\n

Question<\/strong>  Do normotensive living kidney donors, compared with nondonors, have a higher risk of hypertension in the first 7 years following donation?<\/p>\n\n\n\n

Findings<\/strong>  In this 17-center prospective cohort study that included 924 living kidney donors and 396 nondonors, there were no significant between-group differences in the risk of hypertension and no significant between-group differences in mean blood pressure or the change in blood pressure during a median follow-up of 7.3 years.<\/p>\n\n\n\n

Meaning<\/strong>  After accounting for differences in baseline risk, living donors had a similar risk of hypertension as nondonors in the 7 years following donation and no significant difference in mean blood pressure.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  Recent guidelines call for better evidence on health outcomes after living kidney donation.<\/p>\n\n\n\n

Objective<\/strong>  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.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  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.<\/p>\n\n\n\n

Exposure<\/strong>  Living kidney donation.<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  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]).<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0Among the 924 donors, 66% were female; they had a mean age of 47 years and a mean eGFR of 100 mL\/min\/1.73 m2<\/sup>. 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 m2<\/sup>), donors had a 1.4-mL\/min\/1.73 m2<\/sup>\u00a0(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 m2<\/sup>\u00a0at 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).<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong>  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 m2<\/sup> at least once in follow-up.<\/p>\n\n\n\n

Trial Registration<\/strong>  ClinicalTrials.gov Identifier: NCT00936078<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  May 23, 2024 Hyp […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/26116"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=26116"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/26116\/revisions"}],"predecessor-version":[{"id":26460,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/26116\/revisions\/26460"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=26116"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=26116"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=26116"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}