A Kaul1, R K Sharma, A Gupta, U Singh. 1. Department of Nephrology & Biostatistics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow.
Abstract
AIM: Elucidate the incidence and causes of post transplant hypertension in our transplant population. METHODS: All patients transplanted between June 1989 Dec 2002 who had a functioning graft of 6 months post transplant were studied. Hypertension was defined as Systolic BP > or = 140 mmHg/Diastolic BP > or = 90 mmHg/usage of antihypertensive medication. Donor and recepient characteristics were recorded and compared. 86.2% (485) were hypertensive in post renal transplant period. RESULTS: Age > or = 40 years, male sex, graft dysfunction, use of calcineurin inhibitors, high doses of steroids, chronic rejection were statistically significant correlate of post RTHT in univariate analysis. On multivariate analysis, age > or = 40 yrs (RR 2.06, 95% CI, 1.20-3.54), use of cyclosporine (RR 2.70, 95% CI, 1.54-4.75), usage of high doses of steroids (RR 2.56, 95% CI, 1.31-4.98) only were associated with post transplant hypertension. The patient and graft survival was inferior in patients with post transplant hypertension. The systolic BP at 12 months, diastolic BP at 6 months and 12 months post transplant, had significant detrimental effect on renal allografts survival. CONCLUSION: Diagnosis, identification of risk factors and aggressive treatment of post transplant HT and of the various modifiable risk factors is important for improving renal allograft and patient survival.
AIM: Elucidate the incidence and causes of post transplant hypertension in our transplant population. METHODS: All patients transplanted between June 1989 Dec 2002 who had a functioning graft of 6 months post transplant were studied. Hypertension was defined as Systolic BP > or = 140 mmHg/Diastolic BP > or = 90 mmHg/usage of antihypertensive medication. Donor and recepient characteristics were recorded and compared. 86.2% (485) were hypertensive in post renal transplant period. RESULTS: Age > or = 40 years, male sex, graft dysfunction, use of calcineurin inhibitors, high doses of steroids, chronic rejection were statistically significant correlate of post RTHT in univariate analysis. On multivariate analysis, age > or = 40 yrs (RR 2.06, 95% CI, 1.20-3.54), use of cyclosporine (RR 2.70, 95% CI, 1.54-4.75), usage of high doses of steroids (RR 2.56, 95% CI, 1.31-4.98) only were associated with post transplant hypertension. The patient and graft survival was inferior in patients with post transplant hypertension. The systolic BP at 12 months, diastolic BP at 6 months and 12 months post transplant, had significant detrimental effect on renal allografts survival. CONCLUSION: Diagnosis, identification of risk factors and aggressive treatment of post transplant HT and of the various modifiable risk factors is important for improving renal allograft and patient survival.
Authors: Mary N Kubo; Joshua K Kayima; Anthony J Were; Mohammed S Ezzi; Seth O McLigeyo; Elijah N Ogola Journal: Int J Hypertens Date: 2016-12-07 Impact factor: 2.420