Does Hypertension Remain after Kidney Transplantation?
Hypertension is a common complication of kidney transplantation with the prevalence of 80%. Studies in adults have shown a high prevalence of hypertension (HTN) in the first three months of transplantation while this rate is reduced to 50- 60% at the end of the first year. HTN remains as a major risk factor for cardiovascular diseases, lower graft survival rates and poor function of transplanted kidney in adults and children. In this retrospective study, medical records of 400 kidney transplantation patients of Sina Hospital were evaluated. Patients were followed monthly for the 1st year, every two months in the 2nd year and every three months after that. In this study 244 (61%) patients were male. Mean ± SD age of recipients was 39.3 ± 13.8 years. In most patients (40.8%) the cause of end-stage renal disease (ESRD) was unknown followed by HTN (26.3%). A total of 166 (41.5%) patients had been hypertensive before transplantation and 234 (58.5%) had normal blood pressure. Among these 234 individuals, 94 (40.2%) developed post-transplantation HTN. On the other hand, among 166 pre-transplant hypertensive patients, 86 patients (56.8%) remained hypertensive after transplantation. Totally 180 (45%) patients had post-transplantation HTN and 220 patients (55%) didn't develop HTN. Based on the findings, the incidence of post-transplantation hypertension is high, and kidney transplantation does not lead to remission of hypertension. On the other hand, hypertension is one of the main causes of ESRD. Thus, early screening of hypertension can prevent kidney damage and reduce further problems in renal transplant recipients.
Malek-Hosseini SA, Ghahramani N, Behzadi S, et al. Incidence of posttransplant hypertension among renal allograft recipients. Trans Proc 1998:30(3):775-6.
Zeier M, Mandelbaum A, Ritz E. Hypertension in the transplanted patient. Nephron.1998;80(3):257-68.
Kasiske BL, Vazquez MA, Harmon WE, et al. Recommendations for the outpatient surveillance of renal transplant recipients. J J Am Soc Nephrol 2000;11(Suppl1):S1-S86.
Budde K, Waiser J, Fritsche L, et al. Hypertension in patients after renal transplantation. Trans Proc 1997:29(1-2):209-11.
Sorof JM, Sullivan EK, Tejani A, et al. Antihypertensive Medication and Renal Allograft Failure A North American Pediatric Renal Transplant Cooperative Study Report. J J Am Soc Nephrol 1999;10(6):1324-30.
Mitsnefes MM, Khoury PR, McEnery PT. Early posttransplantation hypertension and poor long-term renal allograft survival in pediatric patients. J Pediatr 2003;143(1):98-103.
Sorof JM, Goldstein SL, Brewer ED, et al. Use of antihypertensive medications and posttransplant renal allograft function in children. Pediatr Trans 2000;4(1):21-7.
Midtvedt K, Hartmann A. Hypertension after kidney transplantation: are treatment guidelines emerging? Nephrol Dial Transplant 2002;17(7):1166-9.
Ponticelli C, Montagnino G, Aroldi A, et al. Hypertension after renal transplantation. Am J Kidney Dis 1993;21(Suppl 2):73-8.
Luke RG. Hypertension in renal transplant recipients. Kidney Int 1987;31(4):1024-37.
Kon V, Sugiura M, Inagami T, et al. Role of endothelin in cyclosporine-induced glomerular dysfunction. Kidney Int 1990;37(6):1487-91.
Curtis JJ, Luke RG, Jones P, et al. Hypertension in cyclosporine-treated renal transplant recipients is sodium dependent. Am J Med 1988;85(2):134-8.
Paripovic D, Kostic M, Spasojevic B, et al. Masked hypertension and hidden uncontrolled hypertension after renal transplantation. Pediatr Nephrol 2010;25(9):1719-24.
First MR, Neylan JF, Rocher LL, et al. Hypertension after renal transplantation. J Am Soc Nephrol 1994;4(8 Suppl):S30-6.
Textor SC, Canzanello vJ, Taler SJ, et al., editors. Cyclosporine-induced hypertension after transplantation. Mayo Clin Proc 1994:69(12):1182-93.
Lezaic V, Naumovic R, Stanic M, et al. Factors affecting graft function in pediatric and adult recipients of adult live donor kidney transplants. Pediatr Transplant,2007;11(8):906-13.
Veenstra DL, Best JH, Hornberger J, et al. Incidence and long-term cost of steroid-related side effects after renal transplantation. Am J Kidney Dis 1999;33(5):829-39.
Venkata C, Ram S, Toto R, et al. Fate of hypertension (HTN) before and after kidney transplantation in patients with end stage renal disease (ESRD). AJH 2002;15(3):172A.
Opelz G, Wujciak T, Ritz E. Association of chronic kidney graft failure with recipient blood pressure. Kidney Int 1998;53(1):217-22.
Kasiske BL, Anjum S, Shah R, et al. Hypertension after kidney transplantation. Am J Kidney Dis 2004;43(6):1071-81.
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