Antihypertensive Treatment in Kidney Transplant Recipients—A Current Single Center Experience

• Main Authors: Ulrich Jehn, Katharina Schütte-Nütgen, Markus Strauss, Jan Kunert, Hermann Pavenstädt, Gerold Thölking, Barbara Suwelack, Stefan Reuter
• Format: Article
• Language: English
• Published: MDPI AG 2020-12-01
• Series: Journal of Clinical Medicine
• Subjects: kidney transplantation; post-transplant care; arterial hypertension; antihypertensives; allograft failure
• Online Access: https://www.mdpi.com/2077-0383/9/12/3969

Arterial hypertension affects the survival of the kidney graft and the cardiovascular morbidity and mortality of the recipient after kidney transplantation (KTx). Thus, antihypertensive treatment is necessary for a vast majority of these patients. Long-term data on antihypertensive drugs and their effects on allograft function after KTx is still limited, and further investigation is required. We retrospectively analyzed a cohort of 854 recipients who received a kidney transplant at our transplant center between 2007 and 2015 with regard to antihypertensive treatment and its influence on graft function and survival. 1-y after KTx, 95.3% patients were treated with antihypertensive therapy. Of these, 38.6% received mono- or dual-drug therapy, 38.0% received three to four drugs and 8.1% were on a regimen of ≥5 drugs. Beta-blockers were the most frequently used antihypertensive agents (68.1%). Neither the use of angiotensin-converting enzyme inhibitor/angiotensin receptor blockers (51.9%) and calcium channel blockers (51.5%), nor the use the use of loop diuretics (38.7%) affected allograft survival. Arterial hypertension and the number of antihypertensive agents were associated with unfavorable allograft outcomes (each <i>p</i><i> </i>< 0.001). In addition to the well-known risk factors of cold ischemic time and acute rejection episodes, the number of antihypertensive drugs after one year, which reflects the severity of hypertension, is a strong predictor of unfavorable allograft survival.