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Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
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Diagnostic and therapeutic challenges in implementing hypertension management after kidney transplantation

Ekamol Tantisattamo1,2,3,4, Antoney J Ferrey1, Uttam G Reddy1

  • 1American Heart Association Comprehensive Hypertension Center at the University of California Irvine Medical Center, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine School of Medicine, Orange, California.

Current Opinion in Nephrology and Hypertension
|November 8, 2024
PubMed

Insights

Accurate blood pressure (BP) measurement and hypertension management are crucial for kidney transplant recipients (KTR). Guidelines should consider post-transplant factors, with 24-h ambulatory BP monitoring as the gold standard for diagnosis.

Area of Science:

  • Nephrology
  • Cardiology
  • Transplant Medicine

Background:

  • Hypertension is a common complication in kidney transplant recipients (KTR).
  • Standardized evidence for BP measurement and hypertension management in KTR is limited.
  • Post-transplant factors influence BP and require tailored management strategies.

Purpose of the Study:

  • To review current evidence and provide guidance on BP measurement and hypertension management in KTR.
  • To highlight the importance of accurate BP monitoring techniques.
  • To discuss BP targets and therapeutic options in the context of kidney transplantation.

Main Methods:

  • Review of current literature on BP measurement and hypertension in KTR.
  • Analysis of factors influencing BP post-transplantation.
  • Discussion of diagnostic gold standards and therapeutic approaches.

Main Results:

  • 24-h ambulatory BP monitoring is the gold standard for diagnosing hypertension in KTR.
  • BP targets may differ from non-transplant patients due to factors like vascular calcification and immunosuppression.
  • Specific BP targets are proposed for immediate, early, and late post-transplant periods.
  • Calcium channel blockers show favorable graft outcomes.
  • Novel treatments are limited by trial ineligibility.

Conclusions:

  • BP measurement and monitoring in KTR should adapt standard guidelines considering post-transplant factors and immunosuppression.
  • Further research is needed for novel treatment options in KTR hypertension.
Abstract

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