Hypertension in Kidney Transplant Recipients : Where Are We Today?

PURPOSE OF REVIEW: Cardiovascular disease is the leading cause of death and allograft loss among kidney transplant recipients, and hypertension is an independent risk factor for cardiovascular morbidity of this patient population. The etiology of hypertension is multifactorial, including pre-transplant volume overload, post-transplant recipient and donor-associated variables, and transplant-specific causes (immunosuppressive medications, allograft dysfunction and surgical complications such as transplant artery stenosis).

RECENT FINDINGS: No randomized controlled trials have assessed the optimal blood pressure targets and explored the best antihypertensive regimen for kidney transplant recipients. According to the large observational studies, it is reasonable to achieve a blood pressure goal of equal to or less than 130/80 mmHg in the long-term follow-up for minimizing the cardiovascular morbidity. The selection of antihypertensive agents should be based on the patient's co-morbidities; however, the initial choice could be calcium channel blockers especially in the first few months of transplantation. In patients with cardiovascular indications of renin-angiotensin-aldosterone system inhibition, given the well-described benefits in diabetic and proteinuric patients, it is reasonable to consider the use of renin-angiotensin-aldosterone system inhibitors. There is a need for future prospective trials in the transplant population to define optimal blood pressure goals and therapies.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:23

Enthalten in:

Current hypertension reports - 23(2021), 4 vom: 13. Apr., Seite 21

Sprache:

Englisch

Beteiligte Personen:

Ari, Elif [VerfasserIn]
Fici, Francesco [VerfasserIn]
Robles, Nicolas Roberto [VerfasserIn]

Links:

Volltext

Themen:

Antihypertensive Agents
Antihypertensive treatment
Calcium channel blocker
Hypertension
Journal Article
Kidney transplantation
Renin-angiotensin system
Review

Anmerkungen:

Date Completed 26.04.2021

Date Revised 05.05.2021

published: Electronic

Citation Status MEDLINE

doi:

10.1007/s11906-021-01139-4

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM324028059