title: Short- and long-term effects of the use of RAAS blockers immediately after renal transplantation.
abstract: BACKGROUND
  The efficacy and safety of renin angiotensin aldosterone system blockers (RAASB's) if introduced immediately after renal transplantation have not been extensively investigated.
  
  
  METHODS
  The medical charts of 142 kidney transplant recipients who received a RAASB in the early postoperative period and of 114 matched controls were analyzed. The RAASB was given primarily for blood pressure control.
  
  
  RESULTS
  117 patients continued to receive and 50 controls remained continuously free of the RAASB in the first year. The RAASB was added on average at postoperative day 8 and the mean duration of follow-up was 5.4 years. Systolic, blood pressure at treatment initiation was increased in the RAASB group (150 ± 17 vs. 141 ± 16, p < 0.001). At discharge from hospital and during follow-up blood pressure was similar in both groups, without differences in GFR, potassium and proteinuria. The endpoints "graft failure" and "graft failure or death from any cause" were significantly better in patients treated with RAASB's (p = 0.03 and p = 0.04, respectively). The treatment effects in the RAASB group persisted even after adjustment for demographic parameters, immunological risk factors, peritransplant risk factors, duration of dialysis prior to transplantation and medical comorbidities.
  
  
  CONCLUSIONS
  Thus, RAASB's can be used effectively and safely to treat hypertension in the early postoperative period after kidney transplantation and are renoprotective in the long term.
authors.affiliation: a Division of Nephrology and Hypertension, Department of Medicine , Hannover Medical School , Hannover , Germany.|b Division of Nephrology and Hypertension, Diabetology and Endocrinology , University Hospital of Magedburg , Magedburg , Germany.
authors.forename: Christos
authors.initials: C
authors.lastname: Chatzikyrkou
authors.affiliation: a Division of Nephrology and Hypertension, Department of Medicine , Hannover Medical School , Hannover , Germany.
authors.forename: Jenny
authors.initials: J
authors.lastname: Eichler
authors.affiliation: c Institute for Biostatistics, Hannover Medical School , Hannover , Germany.
authors.forename: Annika
authors.initials: A
authors.lastname: Karch
authors.affiliation: a Division of Nephrology and Hypertension, Department of Medicine , Hannover Medical School , Hannover , Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Clajus
authors.affiliation: b Division of Nephrology and Hypertension, Diabetology and Endocrinology , University Hospital of Magedburg , Magedburg , Germany.
authors.forename: Florian Gunnar
authors.initials: FG
authors.lastname: Scurt
authors.affiliation: d Department of General, Visceral and Transplantation Surgery , Integrated Research and Treatment Center Transplantation (IFB-Tx), Hannover Medical School , Hannover , Germany.
authors.forename: Wolf
authors.initials: W
authors.lastname: Ramackers
authors.affiliation: d Department of General, Visceral and Transplantation Surgery , Integrated Research and Treatment Center Transplantation (IFB-Tx), Hannover Medical School , Hannover , Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Lehner
authors.affiliation: a Division of Nephrology and Hypertension, Department of Medicine , Hannover Medical School , Hannover , Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Menne
authors.affiliation: a Division of Nephrology and Hypertension, Department of Medicine , Hannover Medical School , Hannover , Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Haller
authors.affiliation: b Division of Nephrology and Hypertension, Diabetology and Endocrinology , University Hospital of Magedburg , Magedburg , Germany.
authors.forename: Peter R
authors.initials: PR
authors.lastname: Mertens
authors.affiliation: a Division of Nephrology and Hypertension, Department of Medicine , Hannover Medical School , Hannover , Germany.
authors.forename: Mario
authors.initials: M
authors.lastname: Schiffer
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D012084:Renin-Angiotensin System / Q000187:drug effects*; D013997:Time Factors
keywords: Acute kidney injury; post-transplant-hypertension; renin-angiotensin-aldosterone-system