O55 ETHNIC DISPARITY IN HYPERTENSION AMONG LIVING KIDNEY DONORS

Background and Objective: Whether the disparity among different ethnicities in living kidney donors (LKD) exists is unknown. We aim to examine the association between ethnicity and the risk of developing hypertension in LKD. Methods: A retrospective cohort study using OPTN/SRTR included adult LKD, who underwent donation between 6/1972 and 9/2022. Systolic and diastolic hypertension (SHTN and DHTN) were defined by SBP ≥130 and DBP ≥80 mmHg, respectively. The association of different ethnicities with the time-to-event of developing SHTN and DHTN was examined by multiple Cox regression. Results: Of 174,311 adult LKD, the mean±SD age was 41±12 years and 60% were female. Hispanic patients account for 13%. Mean pre-donation BP of Hispanics and non-Hispanics were 120±13/73±9 and 122±13/74±9, respectively (mean(SBP difference) -2.1 mmHg, 95%CI -2.3, -1.9, P <0.001; mean(DBP difference) -1.4 mmHg, 95%CI -1.6, -1.3, P <0.001; Figure 1). The median follow-up times for developing SHTN and DHTN were 13.2 (IQR 6.8, 24.4) and 12.2 (IQR 6.3, 24.1) months, respectively and the corresponding incidence rates were 0.020 and 0.003 person-months. After adjusting for age, gender, race, U.S. citizenship, education level, history of pre-donation hypertension, diabetes, pre-donation BMI, SBP, DBP, eGFR, and urine protein:creatinine ratio, Hispanics had 28% significantly greater risk for SHTN (HR 1.28, 95%CI 1.00, 1.63, P 0.046). There were no statistically significant differences in DHTN between Hispanics and non-Hispanics (1.15, 95%CI 0.95, 1.39, P 0.150). Gender was an effect measured modifier with an increased risk of developing SHTN in male, but not female LKD (HR(male) 1.501128, 95%CI 1.082693, 2.081278, P 0.015; HR(female) 1.05, 95%CI 0.72, 1.51, P 0.81) Conclusions: Hispanic LKD, particularly male Hispanics, are at increased risk for developing SHTN compared to non-Hispanics. As the fastest-growing ethnic minority in the United States, strategies to mitigate the risk of developing post-donation HTN in Hispanics should be implemented to avoid long-term medical complications in this at-risk population.