What is it about?
Older age (≥50 years old) is not a barrier for kidney donation; however, for many older individuals hypertension is common. This manuscript describes the 15-year risk of kidney failure and death in older donors using national registry data on 24,533 older kidney donors, including 2,265 who had hypertension at the time of donation. The authors demonstrate that donors with hypertension have a higher risk of kidney failure, but not mortality, over 15 years after donation. However, the absolute risk of kidney failure is small.
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Why is it important?
This study is the largest cohort of older donors to date, allowing us to better understand the risks of kidney failure for an increasing number of medically complex living kidney donors. While controlled hypertension in otherwise eligible older individuals may not be viewed as an absolute contraindication for kidney donation, our findings may help inform discussions with older individuals with hypertension when they consider donating a kidney.
Perspectives
Fortunately, the number of kidney failure events in this population is small. Albeit a rather small risk, practice guidelines for live kidney donor evaluation need to be revisited.
Fawaz Al Ammary, MD PhD
University of California Irvine
Read the Original
This page is a summary of: Risk of ESKD in Older Live Kidney Donors with Hypertension, Clinical Journal of the American Society of Nephrology, June 2019, American Society of Nephrology,
DOI: 10.2215/cjn.14031118.
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