Native Nephrectomy with Renal Transplantation is Associated with a Decrease in Hypertension Medication Requirements for Autosomal Dominant Polycystic Kidney Disease

Ashley M. Shumate, Clinton Bahler, William C. Goggins, Asif Sharfuddin, Chandru Sundaram

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Purpose We assessed hypertensive control after native nephrectomy and renal transplantation in patients with autosomal dominant polycystic kidney disease. Materials and Methods Blood pressure control was studied retrospectively in 118 patients with autosomal dominant polycystic kidney disease who underwent renal transplantation between 2003 and 2013. Overall 54 patients underwent transplantation alone (group 1) and 64 underwent transplantation with concurrent ipsilateral nephrectomy (group 2). Of these 64 patients 32 underwent ipsilateral nephrectomy only (group 2a) and 32 underwent eventual delayed contralateral native nephrectomy (group 2b). The number of antihypertensive drugs and defined daily dose of each antihypertensive was recorded at transplantation and up to 36-month followup. Results Comparing preoperative to postoperative medications at 12, 24 and 36-month followup, transplantation with concurrent ipsilateral nephrectomy had a greater decrease in quantity (-1.2 vs -0.5 medications, p=0.008; -1.1 vs -0.3, p=0.007 and -1.2 vs -0.4, p=0.03, respectively) and defined daily dose of antihypertensive drug (-3.3 vs -1.0, p=0.0008; -2.9 vs -1.0, p=0.006 and -2.7 vs -0.6, p=0.007, respectively) than transplantation alone at each point. Native nephrectomy continued to be a predictor of hypertensive requirements on multivariable analysis (p

Original languageEnglish (US)
Pages (from-to)141-146
Number of pages6
JournalJournal of Urology
Volume195
Issue number1
DOIs
StatePublished - Jan 1 2016

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Keywords

  • autosomal dominant
  • drug dosage calculations
  • hypertension
  • kidney transplantation
  • nephrectomy
  • polycystic kidney

ASJC Scopus subject areas

  • Urology

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