Kidney Week

Abstract: SA-PO969

Increase in Arterial Stiffness in Living Kidney Donors after Kidney Donation

Session Information

• Transplantation: Clinical - 3
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2102 Transplantation: Clinical

Authors

• Kannenkeril, Dennis, Department of Nephrology and Hypertension, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany

Dennis Kannenkeril, MD, MBBS

• Günes-Altan, Merve, Department of Nephrology and Hypertension, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany

Merve Günes-Altan

• Bosch, Agnes, Department of Nephrology and Hypertension, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany

Agnes Bosch, MD

• Striepe, Kristina, Department of Nephrology and Hypertension, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany

Kristina Striepe, MD

• Schiffer, Mario, Department of Nephrology and Hypertension, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany

Mario Schiffer, MD, DrMed, MBA

• Amann, Kerstin U., Department of Nephropathology, Department of Pathology, University Hospital Erlangen, Erlangen, Germany

Kerstin U. Amann, MD

• Schmieder, Roland E., Department of Nephrology and Hypertension, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany

Roland E. Schmieder, MD, FASN

Background

Low glomerular filtration rate (GFR) is associated with high cardiovascular mortality and morbidity. Living kidney donor’s vascular characteristics have been poorly investigated till now. In this analysis, living kidney donors were followed up with respect to vascular parameters for one year after renal donation.

Methods

Blood pressure (BP) and different arterial stiffness parameters were assessed before, 6 months and 1 year after renal donation using a 24-hour blood pressure device (Mobil-o-graph®). Cortical, medullary and total renal perfusion of the donors were assessed using Arterial Spin Labeling MRI before and 6 months after donation. Preimplantation biopsy of the donor kidney was obtained. Biopsies were scored for glomerulosclerosis, interstitial fibrosis, tubular atrophy, and arteriosclerosis.

Results

Twenty-five living kidney donors with mean age of 54±9.4 were followed up for one year. The estimated GFR fell significantly (87.7±15.9 vs. 55.6±10.9 ml/min/1.73m²; p<0.001) and urinary albumin creatinine ratio remained similar to baseline (19.5±18.4 vs. 19.5±12.2 mg/g creatinine; p=0.204) 1 year after donation. Pulse wave velocity (7.5±1.4 vs. 7.8±1.4; p=0.001), peripheral resistance (1.1±0.19 vs. 1.23±0.19;p=0.003), and augmentation index (heart rate corrected) (24.4±5.5 vs. 26.7±6.1;p=0.025) over 24 hours increased significantly 12 months after donation, while no change was observed in systolic and diastolic BP. A relationship has been found between eGFR at baseline and mean 24-hour pulse wave velocity at 12 months (r=-594, p=0.002). An increase in renal cortex perfusion was found 6 months after donation (351±53.4 vs. 388±40.7; p=0.013). The 24-hour systolic BP (116.6±6.8 vs. 129.1±10.7;p=0.011), -diastolic BP (73.2±4.4 vs. 81.3±5.6;p=0.006) and -central systolic BP (118.6± 8.9 vs. 128.9±7.7;p=0.013) at 12 months post donation was significantly higher in donors with renal histological changes compared to donors without renal histological changes, while no difference in BP was noticed at baseline between these groups.

Conclusion

Our data indicates that arterial stiffness increases after living kidney donation. This can be interpreted as an early change before increase in BP. Living donors with chronic renal histological changes tend to develop high BP after donation.