Current Hypertension Reports

, Volume 15, Issue 5, pp 458–469

Hypertension after Kidney Transplantation: A Pathophysiologic Approach

Hypertension Management and Antihypertensive Drugs (HM Siragy and B Waeber, Section Editors)

DOI: 10.1007/s11906-013-0381-0

Cite this article as:
Thomas, B., Taber, D.J. & Srinivas, T.R. Curr Hypertens Rep (2013) 15: 458. doi:10.1007/s11906-013-0381-0

Abstract

Post-transplant hypertension is associated with decreased graft and patient survival and cardiovascular morbidity. Unfortunately, post-transplant hypertension is often poorly controlled. Important risk factors include immunosuppressive medications, complications of the transplant surgery, delayed graft function, rejection, and donor and recipient risk factors. The effects of immunosuppressive medications are multifactorial including increased vascular and sympathetic tone and salt and fluid retention. The immunosuppressive agents most commonly associated with hypertension are glucocorticoids and calcineurin inhibitors. Drug therapy for hypertension should be based on the comorbidities and pathophysiology. Evidence-based approaches to defining and treating hypertension in renal transplant recipients are predominantly extrapolated from large-scale studies performed in the general population. Thus, there continues to be a need for larger studies examining the pathophysiology, diagnosis and treatment of hypertension in renal transplant recipients.

Keywords

Kidney transplantation Hypertension Post-transplant hypertension Ambulatory blood pressure monitoring Self-blood pressure monitoring Immunosuppression Calcineurin inhibitor Glucocorticoids Donor risk factors Recipient risk factors Antihypertensives Cardiovascular outcomes Transplant renal artery stenosis Hypertension management Interstitial fibrosis/tubular atrophy Pathophysiology of hypertension 

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Beje Thomas
    • 1
  • David J. Taber
    • 2
  • Titte R. Srinivas
    • 1
  1. 1.Division of NephrologyMedical University of South CarolinaCharlestonUSA
  2. 2.Division of Transplant SurgeryMedical University of South CarolinaCharlestonUSA

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