Cardiovascular Effects of Unilateral Nephrectomy in Living Kidney Donors at 5 Years

Price, Anna; Moody, William E.; Stoll, Victoria; Vijapurapu, Ravi; Hayer, Manvir; Biasiolli, Luca; Weston, Chris J.; Webster, Rachel; Wesolowski, Roman; McGee, K. C.; Liu, Boyang; Baig, Shanat; Pickup, Luke; Radhakrishnan, Ashwin; Law, Jonathan P; Edwards, Nicola C.; Steeds, Richard P.; Ferro, Charles J.; Townend, Jonathan

doi:10.1161/hypertensionaha.120.15398

Cited by 12 publications

(13 citation statements)

References 52 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Potentially, T 1 and T 2 mapping techniques can provide useful surrogate endpoints to assess the response to any novel treatment approach, as well as to early identify incipient CKD-related cardiac damage. [ 33 , 44 ] In this context, native T 1 effectively served as surrogate endpoint in a randomised trial exploring the effect of a program of intradialytic cycling, which was associated with reductions in LV mass, native T 1 values and pulse wave velocity. [ 45 ]…”

Section: T 1 and T 2 Mappingmentioning

confidence: 99%

T1 and T2 Mapping in Uremic Cardiomyopathy: An Update

Arcari¹,

Camastra²,

Ciolina³

et al. 2022

Card Fail Rev

View full text Add to dashboard Cite

Uremic cardiomyopathy (UC) is the cardiac remodelling that occurs in patients with chronic kidney disease (CKD). It is characterised by a left ventricular (LV) hypertrophy phenotype, diastolic dysfunction and generally preserved LV ejection fraction. UC has a major role mediating the increased rate of cardiovascular events, especially heart failure related, observed in patients with CKD. Recently, the use of T1 and T2 mapping techniques on cardiac MRI has expanded the ability to characterise cardiac involvement in CKD. Native T1 mapping effectively tracks the progression of interstitial fibrosis in UC, whereas T2 mapping analysis suggests the contribution of myocardial oedema, at least in a subgroup of patients. Both T1 and T2 increased values were related to worsening clinical status, myocardial injury and B-type natriuretic peptide release. Studies investigating the prognostic relevance and histology validation of mapping techniques in CKD are awaited.

show abstract

Section: T 1 and T 2 Mappingmentioning

confidence: 99%

T1 and T2 Mapping in Uremic Cardiomyopathy: An Update

Arcari¹,

Camastra²,

Ciolina³

et al. 2022

Card Fail Rev

View full text Add to dashboard Cite

show abstract

“…The decrease is acceptable considering a 50% reduction in renal mass due to nephrectomy and the age of our donors. Post-donation eGFR of the donors with thalassemia minor (71.04 ± 11.54 mL/min/1.73m 2 ) is better than donors with hypertension (61.0 ± 2.0) reported by Textor et al in a 282 days cohort [ 14 ] and we expected that the outcomes could be comparable to healthy donors (67.0 ± 14.0) after 5 years in a study conducted by Price et al [ 15 ].…”

Section: Discussionmentioning

confidence: 87%

Safety, clinical and laboratory characteristics of donors with thalassemia minor in living donor kidney transplant: a case series

Dinh

Beaupha

2021

BMC Nephrol

View full text Add to dashboard Cite

Background Due to the increasing demand for kidney transplants, sometimes donors with underlying medical conditions can be considered for living kidney donor transplant. Thalassemia is amongst the most common inherited disorders of hemoglobin globally, which is not restricted as an exclusion criterion. However, there is currently no study examine the safety and characteristics of kidney donors with thalassemia minor. Methods All eligible live kidney donors between 2016 and 2019 with thalassemia minor at a tertiary hospital were recruited. Baseline characteristics, clinical and laboratory outcomes were investigated. Results Fifteen donors (11 women, 55.5 ± 15.0 year-old) were included with a follow-up duration of 2 (1-4) years since operation. The most prevalent gene mutation among participants was DEL-SEA. No clinical manifestations of anemia were seen but 10 participants had mild anemia diagnosed from blood tests. Cardiovascular, liver and renal function were normal before nephrectomy. Until now, all donors are alive and maintain overall good health. Anemia condition is not affected, and the post-donation eGFR = 71.04 ± 11.54 mL/min/1.73m2 is comparable to outcomes of healthy donors reported in previous studies. Two donors are at risk of proteinuria at 1-year post-transplant with A/C ratio > 30 mg/g. Conclusions Thalassemia minor individuals who are non-transfusion-dependent, without anemia clinical manifestations and have no contraindications to kidney donation are safe to be donors in short-term. An eGFR of at least 80 mL/min/1.73m2 should be considered to avoid low post-donation eGFR, and awareness should be raised on thalassemia donors with even mild albuminuria. Nephrectomy does not worsen thalassemia.

show abstract

“…Also of note is that patients with stable eGFR on repeated measurements also have a markedly attenuated cardiovascular risk [ 46–48 ]. In kidney donors, however, the usual decline over time in GFR does not appear to happen [ 37 , 40 , 41 , 49 ]. For example, in a prospective study of 203 donors and 205 carefully selected controls, donors did not experience any further decline in iohexol-measured GFR from 6 months to 9 years post-donation, whereas the GFR in controls declined by an average of 1.26 mL/min/1.73 m 2 per year [ 40 ].…”

Section: Mortality and Cardiovascular Eventsmentioning

confidence: 99%

“…Similar findings were also observed in a 5-year prospective study of kidney donors using isotopic GFR to measure renal function. In 48 donors studied 5 years post-donation, there had been no further decline in either eGFR or isotopically measured eGFR in donors, whereas the 45 healthy controls had an annual mean reduction in eGFR of 1 ± 2 mL/min/1.73 m 2 [ 37 ].…”

Section: Mortality and Cardiovascular Eventsmentioning

confidence: 99%

“…[ 15 ] in a study from the Netherlands on 761 donors and 1522 propensity score-matched controls from general population cohort studies and a median follow-up period of 8 years found a lower incidence of hypertension in donors. Three studies are perhaps worthy of special mention [ 37 , 38 , 40 ]. All three of these studies recruited controls that had passed the selection criteria for donation except for those that required exposure to radiation.…”

Section: Hypertensionmentioning

confidence: 99%

See 1 more Smart Citation

Risk for subsequent hypertension and cardiovascular disease after living kidney donation: is it clinically relevant?

Ferro

Townend

2021

Clinical Kidney Journal

Self Cite

View full text Add to dashboard Cite

The first successful live donor kidney transplant was performed in 1954. Receiving a kidney transplant from a live kidney donor remains the best option for increasing both life expectancy and quality of life in patients with end-stage kidney disease. However, ever since 1954 there have been multiple questions raised on the ethics of live kidney donation in terms of negative impacts on donor life expectancy. Given the close relationship between reduced kidney function in patients with chronic kidney disease and hypertension, cardiovascular disease, and cardiovascular mortality, information on the impact of kidney donation on these is particularly relevant. In this article we review the existing evidence, focusing on the more recent studies, on the impact of kidney donation on all-cause mortality, cardiovascular mortality, cardiovascular disease, hypertension as well as markers of cardiovascular damage including arterial stiffness and uraemic cardiomyopathy. We also discuss the similarities and differences between the pathological reduction in renal function that occurs in chronic kidney disease with the reduction in renal function that occurs because of a donor nephrectomy. Kidney donors perform an altruistic act that benefits individual patients as well as the wider society. They deserve to have high quality evidence on which to make informed decisions.

show abstract

Cardiovascular Effects of Unilateral Nephrectomy in Living Kidney Donors at 5 Years

Cited by 12 publications

References 52 publications

T1 and T2 Mapping in Uremic Cardiomyopathy: An Update

T1 and T2 Mapping in Uremic Cardiomyopathy: An Update

Safety, clinical and laboratory characteristics of donors with thalassemia minor in living donor kidney transplant: a case series

Risk for subsequent hypertension and cardiovascular disease after living kidney donation: is it clinically relevant?

Contact Info

Product

Resources

About