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Hypertension in renal transplantation: donor and recipient risk factors
1Department of Nephrology, Dialysis and Renal Transplantation, Saint Jacques Hospital, Besançon, France. adjusy@wanadoo.fr
Insights
Hypertension is common after kidney transplants. Both recipient factors like pre-transplant high blood pressure and donor factors such as older donor age contribute to this risk in renal transplant recipients.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Transplantation Science
Background:
- Hypertension is a prevalent complication following renal transplantation.
- Identifying risk factors is crucial for managing post-transplant cardiovascular health.
Purpose of the Study:
- To investigate the independent contributions of donor and recipient characteristics to the development of hypertension in renal transplant recipients.
- To elucidate the specific factors associated with increased hypertension risk in this population.
Main Methods:
- Retrospective analysis of 321 renal transplant recipients with functioning grafts at 1 year post-transplant.
- Blood pressure and antihypertensive medication use were assessed at 1 year.
- Multivariate analysis was employed to identify significant risk factors.
Main Results:
- A high prevalence of hypertension (82%) was observed at 1 year post-transplant.
- Recipient factors including pretransplant hypertension, urinary protein excretion, and BMI were associated with hypertension.
- Donor factors such as older donor age and aortorenal atheroma also significantly increased hypertension risk.
- Use of calcineurin inhibitors, particularly cyclosporine, was linked to higher rates of hypertension.
Conclusions:
- Both donor-related and recipient-related factors play a significant role in the development of hypertension after renal transplantation.
- These findings highlight the need for comprehensive risk assessment and management strategies in renal transplant recipients.
Aims:
To determine the respective roles of donor and recipient factors in the subsequent development of hypertension after renal transplantation.
Patients And Methods:
All the patients transplanted between January 1990 and December 1999 who still had a functioning graft 1 year post-transplant (n = 321) were retrospectively studied. Blood pressure was assessed at 1 year post-transplant. Hypertension was defined as a systolic BP > or equal 140 mmHg or diastolic BP > or equal 90 mmHg, or use of antihypertensive medication. Relevant donor and recipient characteristics were recorded.
Results:
Two-hundred-and-sixty-three patients (82%) were hypertensive. In multivariate analysis, pretransplant hypertension (RR, 1.74, 95% CI, 1.07 to 2.87), anticalcineurin use (RR, 2.59, 95% CI, 1.13 to 5.92), urinary protein excretion (RR, 1.84, 95% CI, 1.06 to 3.18), BMI (RR, 1.08, 95% CI, 1.01 to 1.16), donor age (RR, 1.28,95% CI, 1.05 to 1.59, for each 10-year increase in donor age) and donor aortorenal atheroma (OR, 2.34; 95% CI, 1.24 to 4.46) were associated with hypertension. Among patients under calcineurin inhibitors, those receiving cyclosporine were more prone to have hypertension than those receiving tacrolimus (88.7% vs 78%; p = 0.04).
Conclusion:
Both recipient and donor factors contribute to hypertension in RTR.