Living Donor Research Living Donor Risks

Arterial Stiffness and Hyperfiltration

After a kidney is removed, the remaining kidney often adapts (NEVER grows) to compensate for the missing nephrons. This process is known as hyperfiltration or hypertrophy.

One of the problems with hyperfiltration is that no one knows exactly how much function someone’s remaining kidney will pick up. That’s why we talk about losing 20-40% of pre-donation function or regaining approximately 70% of pre-donation function. No one knows for sure, and there is no guarantee (We do know, however, that folks over 50 years of age tend to hyperfiltrate less, as do folks with high pre-donation BMI).


These researchers looked at pre-donation blood pressure and two measures of arterial stiffness for their effect on hyperfiltration. They found that blood pressure seemed not to be a significant factor, but greater arterial stiffness resulted in less post-donation hyperfiltration.

Arterial stiffness refers to the elasticity of the arteries. Arteries, of course, being the blood vessels that deliver the blood away from the heart. Stiffness (lack of elasticity) is strongly related to strokes or other cardiovascular events.


Since potential kidney donors aren’t tested for arterial stiffness during their evaluation, I don’t know if this information will have much short-term impact. Hopefully, other researchers will expand on these results.


For more on arterial stiffness:


Aortic Stiffness: Current Understanding and Future Directions – 2011

Role of arterial stiffness in cardiovascular disease – 2012


Fesler P, Mourad G, du Cailar G, Ribstein J, & Mimran A (2015). Arterial stiffness : an independent determinant of adaptive glomerular hyperfiltration after kidney donation. American journal of physiology. Renal physiology PMID: 25568135

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