Cardiovascular disease and hypertension risk in living kidney donors: An analysis of health administrative data in Ontario, Canada

Amit X. Garg, G. V.Ramesh Prasad, Heather Thiessen Philbrook, Li Ping, Magda Melo, Eric M. Gibney, Greg Knoll, Martin Karpinski, Chirag Parikh, John Gill, Leroy Storsley, Meghan Vlasschaert, Muhammad Mamdani

Research output: Contribution to journalArticle

Abstract

Background.: Knowledge of any harm associated with living kidney donation guides informed consent and living donor follow-up. Risk estimates in the literature are variable, and most studies did not use a healthy control group to assess outcomes attributable to donation. Methods.: We observed a retrospective cohort using health administrative data for donations which occurred in Ontario, Canada between the years 1993 and 2005. There were a total of 1278 living donors and 6359 healthy adults who acted as a control group. Individuals were followed for a mean of 6.2 years (range, 1-13 years) after donation. The primary outcome was a composite of time to death or first cardiovascular event (myocardial infarction, stroke, angioplasty, and bypass surgery). The secondary outcome was time to a diagnosis of hypertension. Results.: There was no significant difference in death or cardiovascular events between donors and controls (1.3% vs. 1.7%; hazard ratio 0.7, 95% confidence interval 0.4-1.2). Donors were more frequently diagnosed with hypertension than controls (16.3% vs. 11.9%, hazard ratio 1.4, 95% confidence interval 1.2-1.7) but were also seen more often by their primary care physicians (median [interquartile range] 3.6 [1.9-6.1] vs. 2.6 [1.4-4.3] visits per person year, P<0.001). Conclusions.: Based on administrative data, the risk of cardiovascular disease was unchanged in the first decade after kidney donation. The observed increase in diagnosed hypertension may be due to nephrectomy or more blood pressure measurements received by donors in follow-up and requires prospective study.

Original languageEnglish (US)
Pages (from-to)399-406
Number of pages8
JournalTransplantation
Volume86
Issue number3
DOIs
StatePublished - Aug 15 2008

Fingerprint

Living Donors
Ontario
Canada
Cardiovascular Diseases
Tissue Donors
Hypertension
Kidney
Health
Confidence Intervals
Control Groups
Primary Care Physicians
Nephrectomy
Informed Consent
Angioplasty
Stroke
Myocardial Infarction
Prospective Studies
Blood Pressure

Keywords

  • Cardiovascular disease
  • Cohort study
  • Hypertension
  • Living kidney donation

ASJC Scopus subject areas

  • Transplantation

Cite this

Cardiovascular disease and hypertension risk in living kidney donors : An analysis of health administrative data in Ontario, Canada. / Garg, Amit X.; Prasad, G. V.Ramesh; Thiessen Philbrook, Heather; Ping, Li; Melo, Magda; Gibney, Eric M.; Knoll, Greg; Karpinski, Martin; Parikh, Chirag; Gill, John; Storsley, Leroy; Vlasschaert, Meghan; Mamdani, Muhammad.

In: Transplantation, Vol. 86, No. 3, 15.08.2008, p. 399-406.

Research output: Contribution to journalArticle

Garg, AX, Prasad, GVR, Thiessen Philbrook, H, Ping, L, Melo, M, Gibney, EM, Knoll, G, Karpinski, M, Parikh, C, Gill, J, Storsley, L, Vlasschaert, M & Mamdani, M 2008, 'Cardiovascular disease and hypertension risk in living kidney donors: An analysis of health administrative data in Ontario, Canada', Transplantation, vol. 86, no. 3, pp. 399-406. https://doi.org/10.1097/TP.0b013e31817ba9e3
Garg, Amit X. ; Prasad, G. V.Ramesh ; Thiessen Philbrook, Heather ; Ping, Li ; Melo, Magda ; Gibney, Eric M. ; Knoll, Greg ; Karpinski, Martin ; Parikh, Chirag ; Gill, John ; Storsley, Leroy ; Vlasschaert, Meghan ; Mamdani, Muhammad. / Cardiovascular disease and hypertension risk in living kidney donors : An analysis of health administrative data in Ontario, Canada. In: Transplantation. 2008 ; Vol. 86, No. 3. pp. 399-406.
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abstract = "Background.: Knowledge of any harm associated with living kidney donation guides informed consent and living donor follow-up. Risk estimates in the literature are variable, and most studies did not use a healthy control group to assess outcomes attributable to donation. Methods.: We observed a retrospective cohort using health administrative data for donations which occurred in Ontario, Canada between the years 1993 and 2005. There were a total of 1278 living donors and 6359 healthy adults who acted as a control group. Individuals were followed for a mean of 6.2 years (range, 1-13 years) after donation. The primary outcome was a composite of time to death or first cardiovascular event (myocardial infarction, stroke, angioplasty, and bypass surgery). The secondary outcome was time to a diagnosis of hypertension. Results.: There was no significant difference in death or cardiovascular events between donors and controls (1.3{\%} vs. 1.7{\%}; hazard ratio 0.7, 95{\%} confidence interval 0.4-1.2). Donors were more frequently diagnosed with hypertension than controls (16.3{\%} vs. 11.9{\%}, hazard ratio 1.4, 95{\%} confidence interval 1.2-1.7) but were also seen more often by their primary care physicians (median [interquartile range] 3.6 [1.9-6.1] vs. 2.6 [1.4-4.3] visits per person year, P<0.001). Conclusions.: Based on administrative data, the risk of cardiovascular disease was unchanged in the first decade after kidney donation. The observed increase in diagnosed hypertension may be due to nephrectomy or more blood pressure measurements received by donors in follow-up and requires prospective study.",
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T1 - Cardiovascular disease and hypertension risk in living kidney donors

T2 - An analysis of health administrative data in Ontario, Canada

AU - Garg, Amit X.

AU - Prasad, G. V.Ramesh

AU - Thiessen Philbrook, Heather

AU - Ping, Li

AU - Melo, Magda

AU - Gibney, Eric M.

AU - Knoll, Greg

AU - Karpinski, Martin

AU - Parikh, Chirag

AU - Gill, John

AU - Storsley, Leroy

AU - Vlasschaert, Meghan

AU - Mamdani, Muhammad

PY - 2008/8/15

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N2 - Background.: Knowledge of any harm associated with living kidney donation guides informed consent and living donor follow-up. Risk estimates in the literature are variable, and most studies did not use a healthy control group to assess outcomes attributable to donation. Methods.: We observed a retrospective cohort using health administrative data for donations which occurred in Ontario, Canada between the years 1993 and 2005. There were a total of 1278 living donors and 6359 healthy adults who acted as a control group. Individuals were followed for a mean of 6.2 years (range, 1-13 years) after donation. The primary outcome was a composite of time to death or first cardiovascular event (myocardial infarction, stroke, angioplasty, and bypass surgery). The secondary outcome was time to a diagnosis of hypertension. Results.: There was no significant difference in death or cardiovascular events between donors and controls (1.3% vs. 1.7%; hazard ratio 0.7, 95% confidence interval 0.4-1.2). Donors were more frequently diagnosed with hypertension than controls (16.3% vs. 11.9%, hazard ratio 1.4, 95% confidence interval 1.2-1.7) but were also seen more often by their primary care physicians (median [interquartile range] 3.6 [1.9-6.1] vs. 2.6 [1.4-4.3] visits per person year, P<0.001). Conclusions.: Based on administrative data, the risk of cardiovascular disease was unchanged in the first decade after kidney donation. The observed increase in diagnosed hypertension may be due to nephrectomy or more blood pressure measurements received by donors in follow-up and requires prospective study.

AB - Background.: Knowledge of any harm associated with living kidney donation guides informed consent and living donor follow-up. Risk estimates in the literature are variable, and most studies did not use a healthy control group to assess outcomes attributable to donation. Methods.: We observed a retrospective cohort using health administrative data for donations which occurred in Ontario, Canada between the years 1993 and 2005. There were a total of 1278 living donors and 6359 healthy adults who acted as a control group. Individuals were followed for a mean of 6.2 years (range, 1-13 years) after donation. The primary outcome was a composite of time to death or first cardiovascular event (myocardial infarction, stroke, angioplasty, and bypass surgery). The secondary outcome was time to a diagnosis of hypertension. Results.: There was no significant difference in death or cardiovascular events between donors and controls (1.3% vs. 1.7%; hazard ratio 0.7, 95% confidence interval 0.4-1.2). Donors were more frequently diagnosed with hypertension than controls (16.3% vs. 11.9%, hazard ratio 1.4, 95% confidence interval 1.2-1.7) but were also seen more often by their primary care physicians (median [interquartile range] 3.6 [1.9-6.1] vs. 2.6 [1.4-4.3] visits per person year, P<0.001). Conclusions.: Based on administrative data, the risk of cardiovascular disease was unchanged in the first decade after kidney donation. The observed increase in diagnosed hypertension may be due to nephrectomy or more blood pressure measurements received by donors in follow-up and requires prospective study.

KW - Cardiovascular disease

KW - Cohort study

KW - Hypertension

KW - Living kidney donation

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