Blood Pressure (Mar 2020)

Cardiovascular rEmodelling in living kidNey donorS with reduced glomerular filtration rate: rationale and design of the CENS study

  • Kjersti Benedicte Blom,
  • Kaja Knudsen Bergo,
  • Emil Knut Stenersen Espe,
  • Vigdis Rosseland,
  • Ole Jørgen Grøtta,
  • Geir Mjøen,
  • Anders Åsberg,
  • Stein Bergan,
  • Helga Sanner,
  • Tone Kristin Bergersen,
  • Reidar Bjørnerheim,
  • Morten Skauby,
  • Ingebjørg Seljeflot,
  • Bård Waldum-Grevbo,
  • Dag Olav Dahle,
  • Ivar Sjaastad,
  • Jon Arne Birkeland

DOI
https://doi.org/10.1080/08037051.2019.1684817
Journal volume & issue
Vol. 29, no. 2
pp. 123 – 134

Abstract

Read online

Purpose: Until recently, it has been believed that donating a kidney not represents any risk for development of cardiovascular disease. However, a recent Norwegian epidemiological study suggests that kidney donors have an increased long-term risk of cardiovascular mortality. The pathophysiological mechanisms linking reduced kidney function to cardiovascular disease are not known. Living kidney donors are screened for cardiovascular morbidity before unilateral nephrectomy, and are left with mildly reduced glomerular filtration rate (GFR) after donation. Therefore, they represent an unique model for investigating the pathogenesis linking reduced GFR to cardiovascular disease and cardiovascular remodelling. We present the study design of Cardiovascular rEmodelling in living kidNey donorS with reduced glomerular filtration rate (CENS), which is an investigator-initiated prospective observational study on living kidney donors. The hypothesis is that living kidney donors develop cardiovascular remodelling due to a reduction of GFR. Materials and methods: 60 living kidney donors and 60 age and sex matched healthy controls will be recruited. The controls will be evaluated to fulfil the Norwegian transplantation protocol for living kidney donors. Investigations will be performed at baseline and after 1, 3, 6 and 10 years in both groups. The investigations include cardiac magnetic resonance imaging, echocardiography, bone density scan, flow mediated dilatation, laser Doppler flowmetry, nailfold capillaroscopy, office blood pressure, 24-h ambulatory blood pressure, heart rate variability and investigation of microbiota and biomarkers for inflammation, cardiovascular risk and the calcium-phosphate metabolism. Conclusions: The present study seeks to provide new insight in the pathophysiological mechanisms linking reduced kidney function to cardiovascular disease. In addition, we aim to enlighten predictors of adverse cardiovascular outcome in living kidney donors. The study is registered at Clinical-Trials.gov (identifier: NCT03729557).

Keywords