Predictors of hypertension following successful renal transplantation: a population-based study

Hypertension is common following renal transplantation. It is associated with poorer graft survival as well as reduced expectancy and quality of life among transplant recipients. This study sought to evaluate the prevalence of hypertension and its predictors among a representative sample of the population of adult kidney transplant recipients in southern Brazil.

This cross-sectional, multicenter study evaluated 272 adult kidney transplant recipients. The patients were classified as hypertensive if there was a previous diagnosis of high blood pressure and/or they were receiving antihypertensive drugs. The analysis used multivariate linear regression with the number of antihypertensive agents as a dependent variable.

The final regression model showed that patient age (beta 0.23; 95% confidence interval [CI], 0.04-0.43; P = .02), nonwhite skin color (beta 0.32; 95% CI, 0.09-0.54; P = .005), serum creatinine reciprocal square root (beta 0.15; 95% CI, 0.0001-0.30; P = .05), steroid use (beta 0.62; 95% CI, 0.28-0.95; P < .001), and cyclosporine prescription (beta 0.39; 95% CI, 0.19-0.59; P < .001) were independent predictors of a greater number of antihypertensive drugs.

This study analyzed high blood pressure predictors among a representative sample of a kidney transplant population. Its findings confirmed previous reports that cyclosporine and steroid use are independent predictors of high blood pressure after kidney transplantation, as are older age, nonwhite skin color, and reduced allograft function. The association of cyclosporine and steroid use with the need for a greater number of antihypertensive agents after kidney transplantation must be considered in the choice of an immunosuppressive regimen.