Hypertension and kidney transplantation

Hypertension in kidney transplant patients is a common complication that affects long-term patient and allograft survival. Although multifactorial in nature, at least two causes can be corrected by surgical or radiologic intervention--stenosis and native kidney-associated hypertension. Unfortunately, the current immunosuppressive agents have added to the problem of hypertension. Both prednisone and cyclosporine appear to aggravate posttransplant hypertension. Newer agents are on the horizon that may address this problem. Currently, physicians should consider the possibilities of correctable forms of hypertension. If none are indicated, medical therapy with renal vasodilating drugs such as calcium channel blockers or converting enzyme inhibitors or both along with diuretics are usually effective.