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Living Kidney Donor Blood Pressure, Plasma Arginine & Glomerular Filtration Rate

Two living kidney donor related publications hit the google alerts this weekend.

 

The first, from Serbian researchers, observes that not only does renal function (GFR) decrease abruptly following live donor nephrectomy, so does plasma arginine.

 

Arginine is an animo acid. It plays an important role in cell division, wound healing (which requires cell division), removing ammonia (a toxin) from the body, immune function and the release of hormones.

Supplements of L-Arginine have been shown to reduce blood pressure in folks with hypertension.

 

The authors concluded:

Unilateral nephrectomy causes an early abrupt decrease in plasma arginine and reduction in glomerular filtration rate in LKDs that was associated with increased net protein breakdown in the peripheral tissues and elevated oxidative damage, which has to be considered in their therapy.

 

The second bit of living kidney donor related health news comes from a presentation at the 28th Annual Scientific Meeting of the American Society of Hypertension. A group of physicians at a U.S. transplant center observed that living kidney donors with ‘elevated’ systolic blood pressure (the top/upper number) “had a significantly greater number of potentially adverse cardiovascular (CV) and renal risk factors compared with the donors who had lower” systolic blood pressure (SBP).

The operative word here is ‘elevated’. Systolic blood pressure of 140 or greater is considered hypertensive. These researchers looked at living kidney donors with SBP of 115-139, because other clinical studies (of non-donors) have indicated that  SBP of 115 of higher suggests an increased risk of cardiovascular disease and events.

 

“Elevated blood pressure even within the non-hypertensive range could thus be reflective of a latent risk for adverse cardio-metabolic outcomes in living kidney donors, the early recognition of which could support closer monitoring of such individuals for eventual cardiovascular abnormalities.”

 

 

Just to tie all this together:

– protein in the urine is a symptom of kidney damage, so something we living kidney donors have to protect against.

– a drop in arginine post-nephrectomy coincides with an increase in protein breakdown

– arginine also reduces blood pressure

Meanwhile…

– reduced kidney function is associated with higher risk of cardiovascular disease and risks

– living kidney donors also exhibit an increase in systolic blood pressure post-donation

– an elevated SBP of 115-139 (in anyone) is associated with greater cardiovascular disease and events.

– living kidney donors with an SBP of 115-139 are exhibiting more cardiovascular events.

 

Take care of yourself, kids!

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