Effects of the posttransplant hypertension to the kidney allograft

Harsányi, Márton and Paszt, Attila and Keresztes, Csilla and Skadra, Margit and Borda, Bernadett (2026) Effects of the posttransplant hypertension to the kidney allograft. HYPERTONIA ÉS NEPHROLOGIA, 30 (3). pp. 99-101. ISSN 1418-477X

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Abstract

Introduction: Cardiovascular diseases are the leading causes ofdeath after kidney transplantation, one of the major risk factors of which is posttransplant hypertension (PTHT), which is often unrecognized and therefore untreated.Material and methods: In this study, the incidence and risk factors of PTHT wereexamined. The effect of blood pressure on graft function and that of renin andaldosterone levels on renal function were assessed. The effect of hypertensionon renal histology one year after transplantation was evaluated.Results: The incidence of PTHT was 42%. Regarding the risk factors, no significant difference was revealed. PTHT was significantly higher in cyclosporine users, P=0.021, than in tacrolimus users. Significant differences were found in caseof renal function: serum creatinine P=0.024, urea P=0.005, and eGFR P=0.036 inpatients with PTHT. The analysis of renin and aldosterone levels confirmed thatrenin level were associated with serum creatinine P=0.016 and urea P=0.022 values. The donor’s systolic blood pressure significantly affected the developmentof arteriolar hyalinosis (normal vs. arteriolar hyalinosis; N=13 vs. N=56; P=0.023).The incidence of interstitial fibrosis and tubular atrophy (P=0.0001) and acutecellular rejection (P=0.033) was significantly higher in patients with systolic bloodpressure one year after the surgery.Discussion: The harmful effect of newly developed hypertension after transplantation on the graft was seen even one year after transplantation not only inrenal function.Conclusion: Therefore, we consider it essential to monitor blood pressure regularly and to start antihypertensive therapy if necessary.

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