Spectrum of hypertension in post transplant.

AIM

Elucidate the incidence and causes of post transplant hypertension in our transplant population.

METHODS

All patients transplanted between June 1989 Dec 2002 who had a functioning graft of 6 months post transplant were studied. Hypertension was defined as Systolic BP > or = 140 mmHg/Diastolic BP > or = 90 mmHg/usage of antihypertensive medication. Donor and recepient characteristics were recorded and compared. 86.2% (485) were hypertensive in post renal transplant period.

RESULTS

Age > or = 40 years, male sex, graft dysfunction, use of calcineurin inhibitors, high doses of steroids, chronic rejection were statistically significant correlate of post RTHT in univariate analysis. On multivariate analysis, age > or = 40 yrs (RR 2.06, 95% CI, 1.20-3.54), use of cyclosporine (RR 2.70, 95% CI, 1.54-4.75), usage of high doses of steroids (RR 2.56, 95% CI, 1.31-4.98) only were associated with post transplant hypertension. The patient and graft survival was inferior in patients with post transplant hypertension. The systolic BP at 12 months, diastolic BP at 6 months and 12 months post transplant, had significant detrimental effect on renal allografts survival.

CONCLUSION

Diagnosis, identification of risk factors and aggressive treatment of post transplant HT and of the various modifiable risk factors is important for improving renal allograft and patient survival.