Hypertension in renal transplantation: donor and recipient risk factors.
OBJECTIVE
To determine the respective roles of donor and recipient factors in the subsequent development of hypertension after renal transplantation.


METHODS
All the patients transplanted between January 1990 and December 1999 who still had a functioning graft 1 year post-transplant (n = 321) were retrospectively studied. Blood pressure was assessed at 1 year post-transplant. Hypertension was defined as a systolic BP > or equal 140 mmHg or diastolic BP > or equal 90 mmHg, or use of antihypertensive medication. Relevant donor and recipient characteristics were recorded.


RESULTS
Two-hundred-and-sixty-three patients (82%) were hypertensive. In multivariate analysis, pretransplant hypertension (RR, 1.74, 95% CI, 1.07 to 2.87), anticalcineurin use (RR, 2.59, 95% CI, 1.13 to 5.92), urinary protein excretion (RR, 1.84, 95% CI, 1.06 to 3.18), BMI (RR, 1.08, 95% CI, 1.01 to 1.16), donor age (RR, 1.28,95% CI, 1.05 to 1.59, for each 10-year increase in donor age) and donor aortorenal atheroma (OR, 2.34; 95% CI, 1.24 to 4.46) were associated with hypertension. Among patients under calcineurin inhibitors, those receiving cyclosporine were more prone to have hypertension than those receiving tacrolimus (88.7% vs 78%; p = 0.04).


CONCLUSIONS
Both recipient and donor factors contribute to hypertension in RTR.
Ducloux
D
D
Department of Nephrology, Dialysis and Renal Transplantation, Saint Jacques Hospital, Besançon, France. adjusy@wanadoo.fr
Motte
G
G
Kribs
M
M
Abdelfatah
A B
AB
Bresson-Vautrin
C
C
Rebibou
J M
JM
Chalopin
J M
JM
D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D005260:Female; D015438:Health Behavior; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000209:etiology* / Q000652:urine; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011507:Proteinuria / Q000097:blood / Q000150:complications / Q000652:urine; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014019:Tissue Donors
D007166:Immunosuppressive Agents