Abstract P122: Early Renal Allograft Function and Hypertension after Kidney Transplantation

Abstract

Background: Poor renal allograft function is associated with post-transplant hypertension (HTN). The association between allograft function at an early post-transplant period and HTN is unclear. Method: Of 70 transplant recipients, the difference between serum creatinine (SCr) at the discharge date from kidney transplantation (KT) and those at pre-transplantation (ΔCr) divides the study population into Group 1 (ΔCr ≥80%) and Group 2 (ΔCr <80%). Cox proportional hazard regression is performed to find the association between different ΔCr and post-transplant systolic HTN (SHTN) and diastolic HTN (DHTN) defined by SBP ≥130 and DBP ≥80 mmHg, respectively during a 96-week follow-up period. Results: Mean age±SEM is 52.66±1.43 years and 58.6% is male. Mean length of stay is 8.50±1.35 days. Thirty patients (43%) are in the Groups 1. Mean absolute ΔCr is greater in the Group 1 (ΔCr -7.41±0.43 vs. -3.49±0.42, p <0.001). Compared to Group 1, Group 2 has a 17.1% increased risk of SHTN (HR 1.171, 95%CI 0.715 to 1.918, p 0.530, Fig1A), but has a 24.5% decreased risk of DHTN (HR 0.755, 95%CI 0.417 to 1.367, p 0.353, Fig1B). After adjusting for age, gender, type of induction immunosuppressants, type of KT, and BMI, Group 2 has an 80.2% greater risk for SHTN (HR 1.802, 95%CI 0.976 to 3.325, p 0.060, Fig2A), but has a 6.8% lowered risk of DHTN (HR 0.932, 95%CI 0.467 to 1.857, p 0.840, Fig2B). Conclusions: The degree of change in SCr during immediate post-KT does not predict post-transplant SHTN and DHTN. However, patients with better renal allograft function appear to become less SHTN but more DHTN. The pattern of association between long-term allograft function and SHTN and DHTN needs further studies.