Role of hypertension in kidney transplant recipients
Loutradis, Charalampos Sarafidis, Pantelis Marinaki, Smaragdi Berry, Miriam Borrows, Richard Sharif, Adnan Ferro, Charles J
Loutradis, Charalampos
Sarafidis, Pantelis
Marinaki, Smaragdi
Berry, Miriam
Borrows, Richard
Sharif, Adnan
Ferro, Charles J
Citations
Altmetric:
Affiliation
University Hospitals Birmingham NHS Trust; Hippokration Hospital; Aristotle University of Thessaloniki; Laiko General Hospital; National and Kapodistrian University; University of Birmingham
Other Contributors
Publication date
2021-05-04
Collections
Research Projects
Organizational Units
Journal Issue
Abstract
Cardiovascular events are one of the leading causes of mortality in kidney transplant recipients. Hypertension is the most common comorbidity accompanying chronic kidney disease, with prevalence remaining as high as 90% even after kidney transplantation. It is often poorly controlled. Abnormal blood pressure profiles, such as masked or white-coat hypertension, are also extremely common in these patients. The pathophysiology of blood pressure elevation in kidney transplant recipients is complex and includes transplantation-specific risk factors, which are added to the traditional or chronic kidney disease-related factors. Despite these observations, hypertension management has been an under-researched area in kidney transplantation. Thus, relevant evidence derives either from studies in the general population or from small trials in kidney transplant recipients. Based on the relevant guidelines in the general population, lifestyle modifications should probably be applied as the first step of hypertension management in kidney transplant recipients. The optimal pharmacological management of hypertension in kidney transplant recipients is also not clear. Dihydropyridine calcium channel blockers are commonly used as first line agents because of their lack of adverse effects on the kidney, while other antihypertensive drug classes are under-utilised due to fear of the possible haemodynamic consequences on renal function. This review summarizes the existing data on the pathophysiology, diagnosis, prognostic significance and management of hypertension in kidney transplantation.
Citation
Loutradis C, Sarafidis P, Marinaki S, Berry M, Borrows R, Sharif A, Ferro CJ. Role of hypertension in kidney transplant recipients. J Hum Hypertens. 2021 Nov;35(11):958-969. doi: 10.1038/s41371-021-00540-5. Epub 2021 May 4
Type
Article