Undergoing nephrectomy for a benign or malignant kidney tumor is associated with de novo hypertension, a new study finds.
Pierre Bigot, MD, PhD, of Angers University Hospital in France, and colleagues prospectively followed 182 patients (median age 54 years) without pre-existing hypertension who underwent nephrectomy at 7 French centers. By 6 months, de novo hypertension developed in 31 patients (19.2%), the investigators reported in BJU International. Overall, 43 patients (26.3%) experienced a rise in systolic and/or diastolic ambulatory blood pressure of at least 10 mmHg or started antihypertensive therapy.
The type of surgery did not influence hypertension risk. De novo hypertension developed in 21.7% of the partial nephrectomy group and 15.7% of the radical nephrectomy group, a nonsignificant difference. Whether partial nephrectomy was performed with arterial clamping or off-clamp had no bearing on blood pressure readings. Mean plasma renin levels also did not differ significantly: 18.5 IU before surgery vs 16 IU after surgery.
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In a multivariable analysis, each 1-year increase in age and 1-unit increase in body mass index were significantly associated with 7% and 14% increased odds of de novo hypertension, respectively. Pre-existing chronic kidney disease, benign vs malignant tumor, tumor size, operative time, and perioperative complications were not predictive. Male vs female gender was significantly associated with a 2.7-fold increased risk of a 10 mmHg or greater rise in blood pressure within 6 months; each 1-year increase in age was significantly associated with a 5% increased risk, the investigators reported.
“In our study, 26% of our patients showed a significant increase in [blood pressure],” Dr Bigot’s team wrote. “We believe this shows that careful monitoring of [blood pressure] after kidney cancer surgery should be targeted to potentially prevent cardiovascular events.”
Reference
Bigot P, Bernhard JC, Khene ZE, et al. Nephrectomy for kidney tumour increases the risk of de novo arterial hypertension. BJU Int. Published online July 11, 2023. doi:10.1111/bju.16124
