{"doi":"10.1111/ctr.14293","title":"Renal function outcomes and kidney biopsy features of living kidney donors with hypertension","abstract":"BACKGROUND: The medium- to long-term outcomes of living kidney donors with hypertension compared to normotensive donors are not well understood, especially with the recent changes in hypertension guidelines. METHODS: We studied a cohort of 950 living kidney donors using different definitions of hypertension based on either ≥140/90 or ≥130/80 mmHg thresholds and based on either office or ambulatory blood pressure readings. Microstructural features on kidney biopsy at the time of donation were compared using different definitions of hypertension. RESULTS: at a median follow-up of 10 years postdonation, though there was a borderline association with ambulatory blood pressure ≥ 130/80 mmHg predicting a 40% decline in eGFR (OR = 1.53, 1.00-2.36; p = .051). Proteinuria was predicted by office blood pressure ≥ 140/90 mmHg and by nondipper profile on nocturnal ambulatory blood pressure measurements. At the time of donation, larger glomeruli and arterial hyalinosis on biopsy were associated with hypertension defined by either ≥140/90 or ≥130/80 mmHg (by office or ambulatory measurements). Nocturnal nondipper status was associated with larger glomeruli size but not arteriolar hyalinosis when compared to dippers. CONCLUSIONS: In programs that accept donors with controlled hypertension, various definitions of hypertension are associated with histological findings in the donated kidney, but none predict a clinically significant decline in kidney function 10 years after donation. These data support allowing healthy individuals with controlled hypertension to donate a kidney. However, donors with office hypertension (≥140/90 mmHg) and nondippers (regardless of hypertension status) are at greater long-term risk for proteinuria, and particularly for these donors, longer follow-up is warranted.","journal":"Clinical Transplantation","year":2021,"id":190735,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":13,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8403,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":495411,"name":"Aidan F. Mullan","orcid":"0000-0001-8076-6935","position":1,"is_corresponding":false},{"id":703300,"name":"Aleksandar Đenić","orcid":"0000-0001-9157-5405","position":2,"is_corresponding":false},{"id":377104,"name":"Matthew R. D’Costa","orcid":"0000-0001-8487-9806","position":3,"is_corresponding":false},{"id":722682,"name":"Ryan Iverson","orcid":null,"position":4,"is_corresponding":false},{"id":253903,"name":"Walter K. Kremers","orcid":"0000-0001-5714-3473","position":5,"is_corresponding":false},{"id":290231,"name":"Mariam P. Alexander","orcid":null,"position":6,"is_corresponding":false},{"id":335454,"name":"Stephen C. Textor","orcid":null,"position":7,"is_corresponding":false},{"id":755062,"name":"Sandra J. Taler","orcid":"0000-0003-4149-2278","position":8,"is_corresponding":false},{"id":646593,"name":"Mark D. Stegall","orcid":"0000-0002-1392-0792","position":9,"is_corresponding":false},{"id":703301,"name":"Joshua J. Augustine","orcid":"0000-0002-8625-9288","position":10,"is_corresponding":false},{"id":755063,"name":"Naim Issa","orcid":"0000-0003-3165-5184","position":11,"is_corresponding":false},{"id":339336,"name":"Andrew D. Rule","orcid":"0000-0003-0338-7784","position":12,"is_corresponding":false},{"id":755061,"name":"Massini Merzkani","orcid":"0000-0003-3979-3418","position":0,"is_corresponding":true}],"reference_count":49,"raw_metadata":null,"created_at":"2026-07-18T23:49:26.966524Z","pmid":"33745214","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}