Arterial hypertension (HT) is common in renal transplant recipients (RTRs) and control of HT is not optimal in this high risk population. Previous study showed that metabolic syndrome is emerged as strong predictors of poor HT control. Also, also persistent hyperparathyroidism is common in RTRs and elevated serum parathyroid (PTH) levels are related with an increased risk of HT development. RTRs, regardless of achieved renal function, may experience resistant hypertension (RH). The aim of this a cross-sectional was to analyse the prevalence of RH and identified possible factors associated with resistant HT in RTRs.
Design and method:
The 198 RTRs (aged 58.07 ± 12.07 years) were investigated. For each RTRs patient data about number of antihypertensive drugs were collected by interviewing participants, as well as by reviewing participants’ medical records. Serum urea, creatinine, glucose, total cholesterol, low density lipoprotein (LDL) cholesterol, calcium, phosphorus, PTH and urates were measured for each RTRs. Therefore, the systolic (SBP) and diastolic blood pressure (DBP) was measured and body mass index (BMI) was calculated for each patient.
The results showed that 189 (95.45%) RTRs have HT and 85 (44.97%) RTRs were taking less than 3 antihypertensive drugs and 104 (55.03%) were taking 3 or more antihypertensive drugs (one of these was diuretic). Also, when we divided RTRs in two groups according number of antihypertensive drugs (<3 or > = 3 antihypertensive drugs) statistically significant difference in BMI, SBP, creatinine, urea, glucose, total cholesterol, LDL cholesterol, PTH and urate level was found as shown in Table 1.
These data suggested that RH is prevalent in RTRs and that elevated serum PTH levels might be related with RH in RTRs. Also, features of metabolic syndrome and other comorbidity that are common in RTRs (diabetes, chronic graft failure, hyperlipidaemia, hyperuricemia) might be related for increased risk of RH in RTRs. A careful approach to detect true RH and rule out all this potential causes is warranted. Also, further studies should determine if persistent hyperparathyroidism or its treatment influences blood pressure and long-term post transplantation clinical outcomes.