Hypertension and renal transplantation

Hippokratia 2001, 5(2):51-60

G. Vergoulas


Hypertension after renal transplantation contributes significantly to the cardiovascular death of adults and children. Initially there was a debate about the effect of hypertension on renal graft survival. Recently, however, it has been proved that there is a significantly negative correlation between the levels of systolic and diastolic arterial blood pressure and the long term graft survival6. The negative effect of systolic blood pressure was present even if the diastolic blood pressure was less than 90 mmHg. The prevalence of hypertension is 75-80 % among renal transplant recipients in the immediate post transplant period in the cyclosporine era, while in the precyclosporine era it was 45-50%. The factors causing hypertension after renal transplantation can be discriminated in graft endogenous and exogenous. Hypertension of renal graft recipients is multifactorial and usually these patients have more than one cause of hypertension . During the immediate post transplant period, the positive balance of sodium and water, the acute tubular necrosis, the acute obstruction of the ureter, the acute rejection and the hypercalcemia9 have been incriminated as causes of hypertension. Hypertension after the first transplant trimester is related to corticosteroid, cyclosporine and FK506 use as well as chronic allograft rejection.