Antihypertensive Treatment in Kidney Transplant Recipients-A Current Single Center Experience

Arterial hypertension affects the survival of the kidney graft and the cardiovascular morbidity and mortality of the recipient after kidney transplantation (KTx). Thus, antihypertensive treatment is necessary for a vast majority of these patients. Long-term data on antihypertensive drugs and their effects on allograft function after KTx is still limited, and further investigation is required. We retrospectively analyzed a cohort of 854 recipients who received a kidney transplant at our transplant center between 2007 and 2015 with regard to antihypertensive treatment and its influence on graft function and survival. 1-y after KTx, 95.3% patients were treated with antihypertensive therapy. Of these, 38.6% received mono- or dual-drug therapy, 38.0% received three to four drugs and 8.1% were on a regimen of ≥5 drugs. Beta-blockers were the most frequently used antihypertensive agents (68.1%). Neither the use of angiotensin-converting enzyme inhibitor/angiotensin receptor blockers (51.9%) and calcium channel blockers (51.5%), nor the use the use of loop diuretics (38.7%) affected allograft survival. Arterial hypertension and the number of antihypertensive agents were associated with unfavorable allograft outcomes (each p < 0.001). In addition to the well-known risk factors of cold ischemic time and acute rejection episodes, the number of antihypertensive drugs after one year, which reflects the severity of hypertension, is a strong predictor of unfavorable allograft survival.