Hypertension after Kidney Transplantation: Clinical Significance and Therapeutical Aspects

Galina Severova-Andreevska; Ilina Danilovska; Aleksandar Sikole; Zivko Popov; Ninoslav Ivanovski

doi:10.3889/oamjms.2019.264

Authors

Galina Severova-Andreevska University Clinic of Nephrology, Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
Ilina Danilovska University Clinic of Nephrology, Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
Aleksandar Sikole University Clinic of Nephrology, Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
Zivko Popov Macedonian Academy for Science and Arts, Skopje, Republic of Macedonia; Zan Mitrev Clinic, Skopje, Republic of Macedonia
Ninoslav Ivanovski Zan Mitrev Clinic, Skopje, Republic of Macedonia; Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia

DOI:

https://doi.org/10.3889/oamjms.2019.264

Keywords:

kidney transplant recipients, arterial hypertension, Antihypertensive drugs, review article

Abstract

Most of the kidney transplanted patients develop arterial hypertension after renal transplantation. Together with very well-known and usual risk factors, post-transplant hypertension contributes to the whole cardiovascular morbidity and mortality in the kidney transplant population. The reasons of post-transplant hypertension are factors related to donors and recipients, immunosuppressive therapy like Calcineurin Inhibitors (CNI) and surgery procedures (stenosis and kinking of the renal artery and ureteral obstruction). According to Eighth National Committee (JNC 8) recommendations, blood pressure > 140/90 mmHg is considered as hypertension. The usual antihypertensive drugs used for the control of hypertension are Calcium channel blockers (CCB), Angiotensin-converting enzyme (ACE) inhibitors, Angiotensin â€“II receptor blockers (ARB), B- blockers and diuretics. Follow the KDIGO guidelines the target blood pressure < 140/90 mmHg for patients without proteinuria and < 125/75 mmHg in patients with proteinuria is recommended. Better control of post-transplant hypertension improves the long-term graft and patientâ€™s survival.

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