Calcineurin inhibitors and arterial hypertension in recipients of solid organs

Abstract

Arterial hypertension is an established risk factor for cardiovascular complications. Since the introduction of calcineurin inhibitors (CNI), аrterial hypertension is observed in 50-80% of transplanted patients. Arterial hypertension and transplantation are closely linked, and its association may promote impaired graft and overall survival. We summarize the main mechanisms involved in the genesis of CNI-induced hypertension as follows: impaired renal function with the sodium retaining, endothelial dysfunction, renin-angiotensin-aldosterone system and sympathetic activation, production of vasoconstrictor substances, activation the renal Na+/Cl--cotransporter. Attention is focused on the dose-dependent increase in arterial pressure and the need for further study of the intensity of the pro-hypertensive effect of various calcineurin inhibitors.