Blood pressure and graft outcome in renal transplantation


Berber İ. , Aydin C., Yigit B., Kara V., Yildar M., Duzyol C., ...More

TRANSPLANTATION PROCEEDINGS, vol.37, no.2, pp.997-998, 2005 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 37 Issue: 2
  • Publication Date: 2005
  • Doi Number: 10.1016/j.transproceed.2005.01.021
  • Title of Journal : TRANSPLANTATION PROCEEDINGS
  • Page Numbers: pp.997-998

Abstract

To investigate the effects of blood pressure (BP) on kidney function, we reviewed 116 patients who had a median follow-up of 40.5 months. Systolic and diastolic hypertension (HTN) at month 6 resulted in significantly higher serum creatinine (SCr) levels at 1 year, compared with patients with normal BP, namely, 2.2 versus 1.4 mg/dL (P = .0001) and 1.87 versus 1.5 mg/dL (P = .04), respectively. Mean systolic and diastolic BP at the end of 1 and 6 months were significantly higher among patients who had returned to hemodialysis or who had an SCr >= 2 mg/dL at their last follow-up. Mean age, mean donor age, donor type, and sex had no significant effect on graft function. Patients receiving Rapamune-based treatment (n = 9) had no graft failure; graft outcomes were similar between cyclosporine-based and tacrolimus-based immunosuppression therapy. Patients with biopsy-proved acute rejection showed significantly lower graft survival. By multivariate analysis, systolic HTN at the end of 1 month (P = .006) and 6 months (P = .01), and diastolic HTN at the end of 6 months (P =.04) were independent risk factors for graft outcome. Actuarial 5-year graft survival was 95 %, versus 76 % in patients with normal BP versus systolic HTN at 1 month, respectively (P = .02). A significant difference in 5-year graft survival was observed between patients with normal diastolic BP and diastolic HTN at 6 months (95 % versus 67 %, respectively; P = .001). Since systolic and diastolic BP at different times before and after transplantation correlate with graft function, more attention should be paid to maintain normal BP in patients with renal transplants.