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Hypertension in renal transplant recipients: role of bilateral nephrectomy
Insights
Kidney transplant recipients without bilateral nephrectomy had higher hypertension rates. However, performing nephrectomy after transplantation improved hypertension control in some patients with good renal function.
Area of Science:
- Nephrology
- Transplantation Immunology
Background:
- Kidney transplantation is a vital treatment for end-stage renal disease.
- The presence of native kidneys in transplant recipients can influence post-operative outcomes.
- Hypertension is a common complication following kidney transplantation.
Purpose of the Study:
- To investigate the impact of retaining native kidneys on hypertension development and control in kidney transplant recipients.
- To evaluate the effect of post-transplant bilateral nephrectomy on hypertension management.
Main Methods:
- Retrospective analysis of 81 kidney transplant recipients.
- Comparison of outcomes between recipients with and without bilateral nephrectomy.
- Assessment of renal function and blood pressure control.
Main Results:
- A higher incidence of hypertension was observed in recipients who retained their native kidneys (17/22) compared to those who underwent bilateral nephrectomy (24/59).
- Despite higher hypertension rates, non-nephrectomized recipients showed better renal function.
- In a subset of four non-nephrectomized recipients, subsequent bilateral nephrectomy led to improved hypertension control while maintaining good renal function.
Conclusions:
- Retaining native kidneys in kidney transplant recipients is associated with an increased risk of hypertension.
- Post-transplant bilateral nephrectomy may be a viable strategy to improve hypertension control in select patients with good renal function.
Abstract:
Of 81 transplanted kidneys which functioned for six months or more 59 were transplanted to bilaterally nephrectomized recipients and 22 to recipients who retained their own kidneys. There was an excess of hypertension in the non-nephrectomized group (17/22) as compared to 24/59 in the nephrectomized patients, though renal function was better in the non-nephrectomized group. Hypertension became much easier to control in two of the four non-nephrectomized recipients in whom bilateral nephrectomy was performed after transplantation when renal function was good.