How Does Renal Impairment Affect Vascular Health?

Reduced glomerular filtration rate (GFR) in kidney donors causes changes in the heart and increases cardiovascular risk after surgery, according to new research.

Previous research has suggested that mild kidney impairment, as measured by GFR, is associated with increased risk of cardiovascular disease.
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To understand how GFR in living kidney donors affects left ventricular mass and cardiovascular risk, researchers assessed 68 kidney donors of an average age of 47 and 56 healthy patients of an average age of 44 from 2011 to 2014. Donors were chosen because of the rigorous screening process they experience before donation.

Researchers administered magnetic resonance imaging to all patients at baseline and at 1-year follow-up to track the changes.

Results showed that donors’ GFR decreased by 30% as compared to healthy patients, whose GFR did not change significantly., Donors’ left ventricular mass and mass:volume ratio also increased significantly.

Although there was no change in ambulatory blood pressure, donors’ aortic distensibility and global circumferential strain decreased.

Donors’ various protein levels—including serum uric acid, parathyroid hormone, and fibroblast growth factor-23, among others—also increased.

“Change in GFR was independently associated with change in left ventricular mass,” researchers concluded. “These findings suggest that reduced GFR should be regarded as an independent causative cardiovascular risk factor.”

--Amanda Balbi

Reference:

Moody WE, Ferro CJ, Edwards NC, et al. Cardiovascular effects of unilateral nephrectomy in living kidney donors. Hypertension. Published online before print January 11, 2016. doi:10.1161/HYPERTENSIONAHA.115.06608.