Evaluating Factors Associated With Blood Pressure Control in the Early Post-Kidney Transplant Period

Area of Science:

• Nephrology
• Transplantation
• Cardiovascular Medicine

Background:

• Inadequate hypertension control post-kidney transplant impacts allograft survival and cardiovascular outcomes.
• Risk factors for hypertension in kidney transplant recipients (KTRs) are multifactorial.
• Few studies examine BP control in early post-transplant phases relative to guidelines.

Purpose of the Study:

• To identify factors associated with controlled blood pressure (BP) in KTRs within 30 days post-transplant.
• To evaluate BP control rates at 30, 60, and 90 days post-transplant.
• To analyze changes in antihypertensive medication use and classes pre- and post-transplant.

Main Methods:

• Retrospective evaluation of adult KTRs transplanted between January 2013 and October 2018.
• Coprimary outcomes: BP control at postoperative day (POD) 30 and associated covariates.
• Secondary outcomes: BP control at POD 60/90, medication changes, and antihypertensive drug classes used.

Main Results:

• 44% of KTRs achieved controlled BP by POD 30.
• Controlled BP at POD 30 was associated with younger donor age (P < .001) and absence of donor hypertension (P = .004) in bivariate analysis.
• Multivariate analysis identified younger donor age as an independent predictor of controlled BP at POD 30 (P = .03).

Conclusions:

• Younger donor age is significantly associated with controlled blood pressure in the early post-kidney transplant period.
• Older donor age is linked to uncontrolled BP in KTRs, highlighting the need for vigilant BP management.
• Close BP monitoring is crucial for KTRs receiving grafts from older donors.