Hypertension frequently occurs in patients with renal transplant. The incidence of post-transplant hypertension is also contributed with use of immunosuppressive therapy (corticosteroids, cyclosporine and tacrolimus).
The aim of this study was to determine the frequency and degree of control of arterial hypertension in patients after kidney (KT) and kidney-pancreas transplantation (SPKT).
163 consecutive patients (median age 44, range 18–70 years, 97 M/66F, 102 with KT and 61 with SPKT) have been evaluated for control of blood pressure after transplantation. Blood pressure higher than 130/80 mmHg or taking antihypertensive medications were taken as a criteria for definition of arterial hypertension.
The average systolic pressure in our patients was 124 ± 13 mmHg, diastolic 75 ± 8mmHg. Arterial hypertension had 94% of all patients, 94.1% with KT and 93.4% with SPKT, 9 (6%) patients did not need to take antihypertensive therapy. Systolic pressure of ≤130 mmHg had 119 (73%), and diastolic pressure of ≤80 mmHg had 133 (81%) patients. Both target value (systolic and diastolic pressure) had 111 (68%) patients. Fifty-two (32%) transplanted patients taking one, 52 (32%) patients two and 49 (30%) patients three or more antihypertensive medication. The most frequent drugs used in monotherapy were calcium antagonists in 63.4% of patients, followed by beta-blockers in 19.2%, ACE inhibitors in 10%, AT1 receptor antagonists in 4%, and antagonists of alpha-adrenergic receptor in 3.4%. Two antihypertensive medications were taken in 32% of patients, of which the frequency of prescription is calcium antagonists with 80.7%, beta blockers with 61.5%, alpha-antagonists with 23%, AT1 receptor antagonists with 17.3%, ACE inhibitors 11.5%, diuretics 5.7%, and moxonidine with 3.8%.
The presented results show a high incidence of arterial hypertension in patients with KT and SPKT, which is in line with results from other published studies. The satisfactory blood pressure values were obtained in 68% of our patients. Blood pressure of <130/80 mmHg is an adequate treatment goal.
University Hospital Merkur, Department of Nephrology, Zagreb, Croatia