Predictive Factors of Post-transplant Hypertension in Kidney Transplant Recipients: A Single-Center Retrospective Study

Harsányi, Márton and Paszt, Attila and Soós, Péter and Soós-Halász, Orsolya and Keresztes, Csilla and Skadra, Margit and Borda, Bernadett (2026) Predictive Factors of Post-transplant Hypertension in Kidney Transplant Recipients: A Single-Center Retrospective Study. KIDNEY AND BLOOD PRESSURE RESEARCH. ISSN 1420-4096 (In Press)

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Abstract

Introduction Hypertension (HTN) after kidney transplantation (KTx) has been identified as an important risk factor for chronic allograft injury. The present study aimed to determine the prevalence and possible risk factors for post-transplant HTN. Methods A retrospective cohort study was conducted at our KTx Unit between January 1, 2014 and December 31, 2024, by including patients who regularly underwent home blood pressure monitoring (HBPM). The recipient’s demographic information, laboratory data, and donor characteristics were collected at 6 and 12 months post-transplantation. Blood pressure (BP) thresholds were defined according to the European Society of Hypertension (ESH) guidelines. Logistic regression was used to estimate both the unadjusted and adjusted odds ratio (OR) to identify the potential risk factors for post-transplant HTN and multiple imputation was used for missing data of the donors. Results 280 patients were included in this study. The overall prevalence of HTN was found 49.3% and 53.5% at 6 and 12 months after KTx, respectively. After multivariable adjustment, the predictive factors for HTN 6 months after KTx were male gender (OR, 1.717, 95% CI: 1.007–2.927; P = 0.047) and donor with a medical history of HTN (OR, 2.038, 95% CI: 1.038–4.004; P = 0.039). However, serum uric acid level (OR, 1.004, 95% CI: 1.000–1.007; P = 0.033) and male gender (OR, 2.048, 95% CI: 1.161– 3.614; P = 0.013) were independent risk factors at 12 months. Conclusion The prevalence of HTN is high among kidney transplant recipients. Our study suggests that male gender, hypertensive donor, and serum uric acid level are the potential predictors of HTN after KTx. Further studies are needed to determine the risk factors of HTN in this population.

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