gms | German Medical Science

29. Wissenschaftlicher Kongress der Deutschen Hochdruckliga

Deutsche Hochdruckliga e. V. DHL ® - Deutsche Hypertonie Gesellschaft Deutsches Kompetenzzentrum Bluthochdruck

23. bis 25.11.2005, Berlin

Article

Send article

Blood pressure and antihypertensive treatment determine long-term graft survival in kidney transplant patients

Blutdruck und antihypertensive Therapie bestimmen das Langzeittransplantatüberleben nierentransplantierter Patienten

Meeting Abstract

Search Medline for

  • M. Hausberg - Universitätsklinikum Münster (Münster, D)
  • K. Loley - Universitätsklinikum Münster (Münster, D)
  • A. Levers - Universitätsklinikum Münster (Münster, D)
  • D. Lang - Universitätsklinikum Münster (Münster, D)

Hypertonie 2005. 29. Wissenschaftlicher Kongress der Deutschen Hochdruckliga. Berlin, 23.-25.11.2005. Düsseldorf, Köln: German Medical Science; 2006. Doc05hochP71

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hoch2005/05hoch071.shtml

Published: August 8, 2006

© 2006 Hausberg et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective: Many studies suggest an adverse influence of high blood pressure on kidney graft survival. However, the influence of antihypertensive treatment is less well understood.

Design and Methods: In this retrospective analysis, we included all kidney transplant patients followed at the University of Muenster renal transplant outpatient clinic who had received their graft between 1993 and 2003. Analysis was limited to those 507 patients who had a functioning graft 1 year after transplantation. All patients received a calcineurin inhibitor based immunosuppressive regimen. The goals of the present analysis were first to confirm the influence blood pressure levels on graft survival and second to compare patients who had received a combination of modern antihypertensive drugs, ACE-Inhibitors (ACEI) and calcium antagonists (CCB), for at least 2 years with patients who did not receive either of these drugs.

Results: Average follow-up was 63+2 months. One year after transplantation, blood pressure was controlled (i.e. <130/80 mmHg) in 183 patients (CTR) and not controlled in the remaining 324 patients (NON-CTR). 88,4% of the CTR-patients received antihypertensive treatment as compared to 96,6% in the NON-CTR group (p<0.05). Graft survival was significantly longer in the CTR than in the NON-CTR group (cf. figure, Breslow p<0.05). Importantly, during the first years graft survival was significantly higher in patients receiving both ACEI and CCB (n=204) as compared to patients not receiving either of these drugs (n=138) (cf. Figure 1 [Fig. 1], Breslow p<0.001), a finding more pronounced in the NON-CTR. The same was true for patients receiving ACEI alone vs. not receiving ACEI and for patients receiving CCB alone vs. not receiving CCB.

Conclusions: We conclude that blood pressure control is a strong determinant of long term graft survival in renal transplant patients. Modern antihypertensive drugs, ACEI and CCB, appear to have a beneficial effect on graft survival in renal allograft recipients.