Salzberg Daniel J
Division of Nephrology, University of Maryland Medical Center, 22 South Greene Street, Room N3W143, Baltimore, MD 21201, USA.
Curr Hypertens Rep. 2007 Nov;9(5):422-9. doi: 10.1007/s11906-007-0077-4.
There is a high incidence of hypertension after kidney transplantation, which has been associated with the development of left ventricular hypertrophy, an increased risk for acute rejection, lower graft survival, and increased mortality. The pathogenesis of post-transplant hypertension is multifactorial, and therefore optimum therapy for it is not clearly defined. Historically, use of renin-angiotensin system (RAS) blockade in post-transplant hypertension has been limited given concerns of inducing worsening allograft function. Recent data demonstrated that subjects with post-transplant hypertension can be treated effectively with RAS blockers, and that these agents may offer significant additional benefits beyond blood pressure control. Review of the literature suggests that RAS blockers should be considered as useful agents for treatment of post-transplant hypertension not due to transplant renal artery stenosis.
肾移植后高血压的发生率很高，这与左心室肥厚的发生、急性排斥反应风险增加、移植肾存活率降低及死亡率增加有关。移植后高血压的发病机制是多因素的，因此其最佳治疗方法尚未明确界定。从历史上看，鉴于担心会导致移植肾功能恶化，肾素-血管紧张素系统（RAS）阻滞剂在移植后高血压中的应用一直受到限制。最近的数据表明，移植后高血压患者可以用RAS阻滞剂有效治疗，而且这些药物可能在控制血压之外还能带来显著的额外益处。文献综述表明，RAS阻滞剂应被视为治疗非移植肾动脉狭窄所致移植后高血压的有用药物。
