Hypertension in the kidney transplant recipient

Hani M. Wadei, Stephen C Textor

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Elevated arterial blood pressure is common after kidney transplantation and contributes to shortened patient and allograft survivals and increased fatal and nonfatal cardiovascular events. Unfortunately, current evidence indicates that arterial blood pressure remains poorly controlled in kidney transplant recipients. One concern is how best to evaluate treated levels of arterial pressure in transplant recipients as office and clinic measurements often differ from blood pressure readings obtained using ambulatory blood pressure monitoring. Some antihypertensive drugs interact with immunosuppressive medications and adversely affect electrolyte balance and kidney function, which complicates the management of kidney transplant patients. Target blood pressure readings have been suggested by different guidelines, but patient-specific management plan is still lacking. Understanding the basic mechanisms responsible for the persistent hypertension after kidney transplantation is helpful in drafting patient-directed management plan that includes both pharmacologic and nonpharmacologic interventions to achieve target blood pressure control. In this review, we propose a multilayered treatment plan that addresses hypertension in both the early and late posttransplant periods, bearing in mind complications of antihypertensive medications, interactions with immunosuppressive drugs, patient comorbidities, and patient-specific cardiovascular risk factors in the posttransplant period.

Original languageEnglish (US)
Pages (from-to)105-120
Number of pages16
JournalTransplantation Reviews
Volume24
Issue number3
DOIs
StatePublished - Jul 2010

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Hypertension
Kidney
Arterial Pressure
Immunosuppressive Agents
Blood Pressure
Kidney Transplantation
Antihypertensive Agents
Reading
Ambulatory Blood Pressure Monitoring
Water-Electrolyte Balance
Allografts
Transplant Recipients
Comorbidity
Guidelines
Transplants
Pharmaceutical Preparations
Therapeutics

ASJC Scopus subject areas

  • Transplantation
  • Medicine(all)

Cite this

Hypertension in the kidney transplant recipient. / Wadei, Hani M.; Textor, Stephen C.

In: Transplantation Reviews, Vol. 24, No. 3, 07.2010, p. 105-120.

Research output: Contribution to journalArticle

Wadei, Hani M. ; Textor, Stephen C. / Hypertension in the kidney transplant recipient. In: Transplantation Reviews. 2010 ; Vol. 24, No. 3. pp. 105-120.
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