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Hypertension in chronic kidney disease: the influence of renal transplantation

Maria A Azancot1, Natalia Ramos, Francesc J Moreso

  • 11 Nephrology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain. 2 Address correspondence to: Daniel Serón M.D., Ph.D., Nephrology Department, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain.

Transplantation
|April 29, 2014
PubMed

Insights

Kidney transplant recipients have more severe hypertension than chronic kidney disease patients, particularly during sleep, as revealed by ambulatory blood pressure monitoring. This highlights the need for ABPM in transplant hypertension evaluation.

Area of Science:

  • Nephrology
  • Cardiology
  • Hypertension Research

Background:

  • Hypertension is a major cardiovascular risk factor in chronic kidney disease (CKD) and kidney transplant recipients.
  • The comparative impact of kidney transplantation on hypertension versus advanced CKD is not well-defined.

Purpose of the Study:

  • To compare the prevalence and severity of hypertension in kidney transplant recipients versus patients with advanced CKD and similar renal function.
  • To investigate the role of ambulatory blood pressure monitoring (ABPM) in assessing hypertension in these populations.

Main Methods:

  • Ninety-two kidney transplant recipients and 97 CKD patients (eGFR < 60 mL/min/1.73 m², not on dialysis) were enrolled.
  • Office blood pressure (BP) and 24-hour ABPM were performed at baseline.

Main Results:

  • Office BP did not differ significantly between groups.
  • 24-hour, awake, and sleep systolic blood pressure (SBP) were significantly higher in kidney transplant recipients compared to CKD patients.
  • A higher proportion of transplant recipients exhibited nocturnal hypertension and a non-dipper BP pattern, indicating increased cardiovascular risk.

Conclusions:

  • While office BP measurements are similar, kidney transplant recipients experience more severe hypertension, especially during sleep, when assessed by ABPM.
  • ABPM is crucial for accurately evaluating hypertension in kidney transplant recipients.
  • Transplantation is an independent predictor of elevated 24-hour, awake, and sleep SBP.
Abstract

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