Even the smallest reductions in kidney function could damage the heart, new UK research has found.
Writing in Hypertension, Professor Jonathan Townend, of the Queen Elizabeth Hospital Birmingham, said even in very healthy people, a small reduction in kidney function from normal to just a bit below normal was associated with an increase in the mass of the left ventricle.
Such a change that makes the heart stiffer and impairs its ability to contract.
“Mild chronic kidney disease is common, so if kidney disease really is a cause of heart disease it may be a major public health problem,” he warned.
The researchers tracked 68 living kidney donors to see if the decreases in kidney function that occur after donation were associated with heart and blood vessel changes.
They compared the donors, whose average age was 47, with 56 controls, whose average age was 44, through the first year after surgery.
Compared with controls, the researchers found that kidney donors had an expected decline in kidney function, as measured by the glomerular filtration rate and the appearance of the protein albumin in the urine; an increase in the mass of the left ventricle, which is a strong predictor of heart disease risk; and an increase in measures of heart damage apparent in blood tests, such as troponin.
There was no difference in blood pressure.
“This is evidence that reduction in kidney function itself leads directly to measurable adverse effects on the heart and blood vessels, even without other risk factors. More research is needed to know just what aspects of reduced kidney function are responsible for the effects,” said Dr Townend.
He urged kidney donors not to be concerned about the findings.
“Kidney donors are already highly selected as healthy individuals,” he said.
“Our paper has shown that kidney donation causes very small adverse effects on the heart and blood vessels that took careful and accurate measurements to detect. We do not yet know if these effects are maintained over the long term. Even if there is a small increase in your long-term risk of heart disease after donation, it is still likely that you will be at lower than average risk.”
Townend J, Moody WE, Ferro CJ et al. Cardiovascular Effects of Unilateral Nephrectomy in Living Kidney Donors. Hypertension 11 January 2016. doi: 10.1161/HYPERTENSIONAHA.115.06608
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