Smyrli Maria, Oikonomaki Theodora, Skalioti Chrysanthi, Kapsia Eleni, Boletis Ioannis N, Marinaki Smaragdi
Dialysis Unit, Nefroiatriki Green, Athens, Greece.
Department of Nephrology and Renal Transplantation, Laiko General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
PLoS One. 2025 May 30;20(5):e0325390. doi: 10.1371/journal.pone.0325390. eCollection 2025.
We aimed to conduct a systematic review and meta-analysis (PROSPERO CRD42023480478) regarding the impact of kidney donation on arterial stiffness indices such as pulse wave velocity (PWV) and augmentation index (AIx), along with its effect on blood pressure.
We searched for publications related to kidney/renal donors, arterial stiffness, blood pressure, and cardiovascular risk, and included every study employing those terms. A p-value < 0.05 was considered statistically significant.
Twelve studies and 2059 individuals, with a mean age of 46.53 ± 11.27 years, were included in the analysis. Male donors constituted 40.6% of the participants, and the mean follow-up was 2.62 ± 3.2 years. Eleven studies indicated that systolic (SBP) and diastolic blood pressure remained stable within the first year after nephrectomy. However, as the follow-up period extended, especially beyond one year, both were increased (median difference (MD) of SBP was 2.09 [0.06, 4.12] over the first year and 7.7 [6.96, 8.44] over the 5 years of follow-up). Regarding PWV and AIx, assessed in 6 studies, no fluctuations were observed post-donation (MD of PWV was 0.1620 [-0.0423; 0.3662], and MD of AIx was 8.2265 [3.6450; 12.8080]). In addition, 11 studies revealed a decline in the estimated glomerular filtration rate (eGFR) after nephrectomy (MD -27.4960, p-value < 0.0001), though no albuminuria was observed. Lastly, BMI demonstrated negligible changes throughout the follow-up.
Kidney donation is a relatively safe procedure, and despite the observed decline in eGFR, it does not per se impose further cardiovascular burden on the donors. However, the heterogeneity and the lack of data underscores the need for high-quality studies so as to elucidate the connection between arterial stiffness, blood pressure, and GFR level.
我们旨在进行一项系统评价和荟萃分析（PROSPERO CRD42023480478），以探讨肾捐赠对动脉僵硬度指标（如脉搏波速度（PWV）和增强指数（AIx））的影响及其对血压的作用。
我们检索了与肾/肾脏捐赠者、动脉僵硬度、血压和心血管风险相关的出版物，并纳入了所有使用这些术语的研究。p值<0.05被认为具有统计学意义。
分析纳入了12项研究和2059名个体，平均年龄为46.53±11.27岁。男性捐赠者占参与者的40.6%，平均随访时间为2.62±3.2年。11项研究表明，肾切除术后第一年收缩压（SBP）和舒张压保持稳定。然而，随着随访期延长，尤其是超过一年后，两者均升高（随访第一年SBP的中位数差异（MD）为2.09[0.06，4.12]，随访5年时为7.7[6.96，8.44]）。关于在6项研究中评估的PWV和AIx，捐赠后未观察到波动（PWV的MD为0.1620[-0.0423；0.3662]，AIx的MD为8.2265[3.6450；12.8080]）。此外，11项研究显示肾切除术后估计肾小球滤过率（eGFR）下降（MD -27.4960，p值<0.0001），尽管未观察到蛋白尿。最后，在整个随访过程中，体重指数（BMI）变化可忽略不计。
肾捐赠是一种相对安全的手术，尽管观察到eGFR下降，但它本身不会给捐赠者带来进一步的心血管负担。然而，异质性和数据的缺乏凸显了开展高质量研究以阐明动脉僵硬度、血压和GFR水平之间联系的必要性。
