Short-Term Prognosis of Living-Donor Kidney Transplantation From Hypertensive Donors With High-Normal Albuminuria

Background. High-normal albuminuria (HNA) is an independent predictor of cardiovascular risk in the generalpopulation. Although hypertensive donor (HTD) candidates with HNA were considered acceptable donors by theAmsterdam Forum 2004, the transplant prognosis of HTDs with HNA has not been determined. Therefore, weinvestigated the transplant prognosis of HTDs with HNA.Methods. We retrospectively analyzed 52 adult living-donor kidney transplants performed at Kagawa UniversityHospital. HNA was defined as albuminuria of 15 to 30 mg/g Cr. Changes in kidney function of donors and recipientswere assessed up to 2 years after transplantation.Results. Overall, 38 donors were normotensive and 14 were hypertensive. Nine of 14 HTDs exhibited HNA beforedonation. More HTDs with HNA had arteriosclerotic vasculopathy or glomerulosclerosis than did normotensivedonors (NTDs). Hypertension and the degree of albuminuria did not affect the donors’ posttransplantation kidneyfunction. The risk of discompensatory changes in kidney function after donation was significantly higher in HTDswith HNA than in NTDs (odds ratio, 10.5; 95% confidence interval, 1.51Y72.9; P=0.02). In multivariate analysis, thecoexistence of hypertension and HNA was not significantly associated with discompensatory changes after donation(adjusted odds ratio, 6.04; 95% confidence interval, 0.19Y192; P=0.31). Recipients of HTDs with HNA had similarallograft survival rates but lower allograft function compared with recipients of NTDs.Conclusions. Although further studies are needed to confirm our results, the short-term prognosis of living-donorkidney transplantation was similar between HTDs with HNA and NTDs.Keywords: High-normal albuminuria, Hypertension, Living-donor kidney transplantation, Marginal donor,Preimplantation kidney biopsy.(Transplantation 2013;00: 00Y00)