Long-term blood pressure changes in renal homotransplantation

Long-term blood pressure changes were studied in 50 patients who had undergone renal homotransplantation. Excluded were those subjects with arterial stenosis of the transplanted kidney, acute or rapidly progressive rejection, or recurrent glomerulonephritis, as well as those retaining their own diseased kidney(s). The blood pressure after the end of the first year was stable and, therefore, was utilized as the reference blood pressure for this study. One year after transplantation, hypertension was observed in 20% of the patients. Mean blood pressure was positively correlated with age (P less than .01), body weight (P less than .001), and serum creatinine level (P less than .001), and negatively correlated with maintenance dose of prednisone (P less than .01). A higher incidence of hypertension was observed in cadaver kidney transplantation than in living related-donor transplantation. The study minimizes the role of glucocorticoids and emphasizes the role of renal factors in the mechanism of the long-term blood pressure changes.