Pathogenesis and management of hypertension after kidney transplantation

Arterial hypertension is frequently encountered after renal transplantation and is associated not only with increased cardiovascular complications but also with decreased allograft survival. Adequate blood pressure control is, thus, as essential as immunologic surveillance for the long-term transplant care. Nevertheless, randomized control trials assessing treatment targets in these patients are not available and most of the evidence comes from studies in patients with native chronic kidney disease or the general population. In this regard, the renal transplant recipient is treated according to recommendations that are applicable to nontransplanted individuals at high cardiovascular risk. However, the accepted treatment targets for the nontransplanted population are recently being disputed and this makes the management of posttransplant hypertension even more challenging.