Risk Factors of Arterial Hypertension After Renal Transplantation

Béji, S.; Abderrahim, E.; Kâaroud, H.; Jebali, H.; Abdallah, T. Ben; Younsi, F. El; Moussa, F. Ben; Hamida, F. Ben; Sfaxi, Anis; Blah, M.; Chébil, Mohamed; Ayed, M; Bardi, R.; Gorgi, Y.; Kheder, A.

doi:10.1016/j.transproceed.2007.08.010

Cited by 9 publications

(14 citation statements)

References 10 publications

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“…Despite this, we did note a higher incidence of AHT in cases of male donor or recipient. Be´ji et al (12) demonstrated this increase in renal transplant patients, attributing it to the difference in weight between donor and recipient which would lead to secondary hyperinsulinism and this in turn to AHT.…”

Section: Discussionmentioning

confidence: 97%

Predictor factors for the development of arterial hypertension following heart transplantation

Sánchez‐Lázaro

Martínez‐Dolz

Almenar‐Bonet

et al. 2008

Clinical Transplantation

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Section: Discussionmentioning

confidence: 97%

Predictor factors for the development of arterial hypertension following heart transplantation

Sánchez‐Lázaro

Martínez‐Dolz

Almenar‐Bonet

et al. 2008

Clinical Transplantation

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“…5,63 The various causes for posttransplant hypertension are well-documented in the literature. 1,3,8,64 Given the complexity of the kidney transplant milieu related to the interaction between recipient and donor parameters, and the progressive, cumulative nature of the chronic kidney disease-cardiovascular disease continuuma proper stratification of the different causes of posttransplant hypertension should take into account the different phases of the continuum and the various donor-related and recipient-related factors of each phase (Figure 3). The causes of arterial hypertension in a kidney transplant recipient are diverse, and posttransplant hypertension should be considered a multifactorial disease state rather than a simple phenomenon.…”

Section: Posttransplant Hypertension Pathogenesismentioning

confidence: 99%

“…[1][2][3]9,[51][52][53][54][55][56]59,64,71,73,76,86,[88][89][90][91][92][93] As in the recipient, old age, pre-existing hypertension, diabetes mellitus, subclinical kidney disease, and nephron under dosing (innate, female to male donor, old age, and donorrecipient body mass index mismatch) represent potential causes for development or aggravation of hypertension posttransplant. [1][2][3]9,59,64,71,73,[91][92] New evidence is emerging regarding the potential role of the donor genetic makeup in the pathogenesis of posttransplant hypertension. Kidney recipientrelated healthy volunteers who can be potential donors, exhibit significantly higher pulse wave velocity (an indicator of atherosclerosis) than do nonrelated donors.…”

Section: Donor Factorsmentioning

confidence: 99%

Posttransplant Hypertension: Multipathogenic Disease Process

Barbari

2013

Exp Clin Transplant

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Arterial hypertension is prevalent among kidney transplant recipients. The multifactorial pathogenesis involves the interaction of the donor and the recipient's genetic backgrounds with several environmental parameters that may precede or follow the transplant procedure (eg, the nature of the renal disease, the duration of the chronic kidney disease phase and maintenance dialytic therapy, the commonly associated cardiovascular disease with atherosclerosis and arteriosclerosis, the renal mass at implantation, the immunosuppressive regimen used, life of the graft, and de novo medical and surgical complications that may occur after a transplant). Among calcineurin inhibitors, tacrolimus seems to have a better cardiovascular profile. Steroid-free protocols and calcineurin inhibitor-free regimens seem to be associated with better blood pressure control. Posttransplant hypertension is a major amplifier of the chronic kidney disease-cardiovascular disease continuum. Despite the adverse effects of hypertension on graft and patient survival, blood pressure control remains poor because of the high cardiovascular risk profile of the donor-recipient pair. Although the optimal blood pressure level remains unknown, it is recommended to maintain the blood pressure at < 130/80 mm Hg and < 125/75 mm Hg in the absence or presence of proteinuria.

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“…6 Both recipient and donor factors have been associated with hypertension following kidney transplant. [8][9][10][11][12][13][14][15] Recipient factors associated with hypertension include preexisting hypertension, left ventricular hypertrophy, decreased estimated glomerular filtration rate (eGFR), and native kidney disease. 8 Potential donor factors include older donor age, female sex, and preexisting hypertension.…”

Section: Introductionmentioning

confidence: 99%

Evaluating Factors Associated With Blood Pressure Control in the Early Post–Kidney Transplant Period

2020

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Background: Shortened allograft survival, and cardiovascular morbidity and mortality are consequences of inadequate control of hypertension for kidney transplant recipients (KTRs). Literature suggests the risk is multifactorial, although few studies have evaluated risk factors in relation to guideline recommended blood pressure (BP) goals in the early post–kidney transplant period. This study will elucidate factors associated with controlled BP in KTRs. Methods: Adult KTRs who were transplanted between January 1, 2013, and October 31, 2018, were evaluated. Coprimary outcomes included the proportion of patients who had controlled BP at postoperative day (POD) 30 and identification of the covariates associated with controlled BP at POD 30. Additional outcomes included the proportion of patients who had controlled BP at POD 60 and 90; the difference in the average number of antihypertensive medications taken pretransplant vs POD 30, 60, and 90 for patients with controlled BP at POD 30; antihypertensive use rates pretransplant vs POD 30 and 90; and class of antihypertensive used pretransplant vs POD 30 and 90. Results: At POD 30, 44% (100/226) of patients had controlled BP. The proportion of patients with controlled BP at POD 60 and 90 were 37% (82/220) and 40% (79/196), respectively. In bivariate analyses, lack of recipient hypertension (75% vs 42.5%, P = .04); fewer days on dialysis (1684 vs 2189 days, P = .005); absence of delayed graft function (51.2% vs 35.6%, P = .02); younger donor age (30 vs 40 years, P < .001); absence of donor hypertension (46.9% vs 29.3%, P = .004); and a lower median kidney donor profile index (29% vs 40%, P = .03) were associated with controlled BP at POD 30. In a multivariate analysis, donor age was independently associated with controlled BP at POD 30 ( P = .03). Conclusions: This study suggests that younger donor age is associated with controlled BP, and conversely, older donor age is associated with uncontrolled BP in KTRs in the early post–kidney transplant period. Patients receiving a graft from older donors should have their BP closely monitored.

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Risk Factors of Arterial Hypertension After Renal Transplantation

Cited by 9 publications

References 10 publications

Predictor factors for the development of arterial hypertension following heart transplantation

Predictor factors for the development of arterial hypertension following heart transplantation

Posttransplant Hypertension: Multipathogenic Disease Process

Evaluating Factors Associated With Blood Pressure Control in the Early Post–Kidney Transplant Period

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