title: Effect of hypertension on transplant kidney function: three year of follow-up.
abstract: BACKGROUND
  Hypertension significantly increases the risk for chronic graft loss and accelerates the deterioration of transplanted kidney function. Aggressive control of blood pressure (BP) is recommended in the posttransplant period when maintenance levels of immunosuppressive drugs are achieved. The aim of this study was to investigate whether the improved control improved the graft survival.
  
  
  METHODS
  We compared transplant kidney function in two groups of hypertensive patients matched for age, gender, donor-recipient relation, primary disease, early posttransplant course, and immunosuppressant and hypertensive therapy during 3 years follow-up. The patients were divided into satisfactory and unsatisfactory controlled blood pressure. Group 1 consisted of 98 patients with satisfactory BP control (arterial pressure <160/90 mmHg) and group 2, 98 patients with unsatisfactory BP control.
  
  
  RESULTS
  The mean through levels of cyclosporine in whole blood were similar in both groups and did not exceed 185 ng/mL. A slow but significant increase in mean creatinine levels was observed among group 2 during 3 years follow-up, whereas, among group 1, graft function remained stable. Cardiovascular events were observed only in group 2: stroke in one patient and death because of heart failure in one patient. Factors which correlated with development of post transplant hypertension were age, gender, duration of disease before transplant, and underlying disease.
  
  
  CONCLUSIONS
  Lowering BP, even several years posttransplantation, was associated with improved graft and patient survival in renal transplant recipients.
authors.affiliation: Shiraz Organ Transplant Ward, Nemazee Hospital, Shiraz, Iran. fazelzadeh23@yahoo.com
authors.forename: G A
authors.initials: GA
authors.lastname: Raiss Jalali
authors.forename: A
authors.initials: A
authors.lastname: Fazelzadeh
authors.forename: A R
authors.initials: AR
authors.lastname: Mehdizadeh
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006650:Histocompatibility Testing; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D007165:Immunosuppression Therapy / Q000379:methods; D016030:Kidney Transplantation / Q000276:immunology / Q000502:physiology*; D008297:Male; D011183:Postoperative Complications / Q000503:physiopathology; D013997:Time Factors