Hypertension two years after renal transplantation: causes and consequences.
The incidence of hypertension 2 years after renal transplantation and the possible causes of hypertension were studied retrospectively. A group of 93 patients treated with cyclosporin (CyA), azathioprine (Aza), and/or prednisolone (Pred) were compared to a group of 31 patients treated with Aza and Pred. There were more patients with hypertension in the CyA group (73%) than in the Aza group (58%). Hypertension before transplantation predisposed to hypertension after transplantation. After transplantation, hypertension was most common among patients with polycystic kidney disease (46%), chronic glomerulonephritis (67%), and diabetes (71%). The accumulated immunosuppressive medication (CyA/Pred) did not affect the occurrence of hypertension. Hypertensive patients had significantly poorer graft function than did normotensive patients (serum creatinine level 229 mumol/l vs 162 mumol/l, P < 0.01). The 10-year graft survival was markedly impaired in the group with hypertension (42% vs 65% for normotensives, P < 0.05). The 10-year patient survival was 59% vs 79% (P = NS). The study further confirms the frequent finding that hypertension has a negative effect on graft and patient survival rates.
Warholm
C
C
Karolinska Institute, Department of Medicine, Danderyd Hospital, Sweden.
Wilczek
H
H
Pettersson
E
E
D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D002423:Cause of Death; D005260:Female; D006084:Graft Rejection / Q000150:complications; D006085:Graft Survival; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007674:Kidney Diseases / Q000150:complications* / Q000401:mortality / Q000473:pathology; D016030:Kidney Transplantation / Q000276:immunology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D014019:Tissue Donors; D014184:Transplantation, Homologous
D007166:Immunosuppressive Agents