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Effect of hypertension on transplant kidney function: three year of follow-up
G A Raiss Jalali1, A Fazelzadeh, A R Mehdizadeh
1Shiraz Organ Transplant Ward, Nemazee Hospital, Shiraz, Iran. fazelzadeh23@yahoo.com
Insights
Aggressively controlling high blood pressure (BP) after a kidney transplant improves graft survival and patient outcomes. Stable graft function was observed in patients with satisfactory BP control, unlike those with unsatisfactory control.
Area of Science:
- Nephrology
- Transplantation Immunology
- Cardiovascular Medicine
Background:
- Hypertension is a major risk factor for chronic graft loss and declining kidney function post-transplant.
- Effective blood pressure (BP) management is crucial during the maintenance phase of immunosuppressive therapy.
- This study aimed to determine if improved BP control enhances graft survival rates.
Purpose of the Study:
- To evaluate the impact of satisfactory versus unsatisfactory blood pressure control on renal transplant recipients.
- To assess the long-term effects of blood pressure management on graft function and survival.
Main Methods:
- A 3-year follow-up study comparing two matched groups of hypertensive renal transplant patients.
- Group 1: 98 patients with satisfactory BP control (<160/90 mmHg).
- Group 2: 98 patients with unsatisfactory BP control.
Main Results:
- Renal graft function remained stable in the satisfactory BP control group (Group 1).
- A significant increase in creatinine levels was noted in the unsatisfactory BP control group (Group 2).
- Cardiovascular events, including stroke and heart failure, occurred exclusively in Group 2.
Conclusions:
- Lowering blood pressure post-kidney transplantation is linked to better graft and patient survival.
- Consistent BP management is vital for long-term success in renal transplant recipients.
- Factors influencing post-transplant hypertension include age, gender, disease duration, and underlying conditions.
Background:
Hypertension significantly increases the risk for chronic graft loss and accelerates the deterioration of transplanted kidney function. Aggressive control of blood pressure (BP) is recommended in the posttransplant period when maintenance levels of immunosuppressive drugs are achieved. The aim of this study was to investigate whether the improved control improved the graft survival.
Methods:
We compared transplant kidney function in two groups of hypertensive patients matched for age, gender, donor-recipient relation, primary disease, early posttransplant course, and immunosuppressant and hypertensive therapy during 3 years follow-up. The patients were divided into satisfactory and unsatisfactory controlled blood pressure. Group 1 consisted of 98 patients with satisfactory BP control (arterial pressure <160/90 mmHg) and group 2, 98 patients with unsatisfactory BP control.
Results:
The mean through levels of cyclosporine in whole blood were similar in both groups and did not exceed 185 ng/mL. A slow but significant increase in mean creatinine levels was observed among group 2 during 3 years follow-up, whereas, among group 1, graft function remained stable. Cardiovascular events were observed only in group 2: stroke in one patient and death because of heart failure in one patient. Factors which correlated with development of post transplant hypertension were age, gender, duration of disease before transplant, and underlying disease.
Conclusion:
Lowering BP, even several years posttransplantation, was associated with improved graft and patient survival in renal transplant recipients.
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