Kidney Week

Abstract: TH-PO149

Withdrawal of Antihypertensive Medication One Year After Kidney Transplantation: Korean Cohort Study for Outcome in Patients with Kidney Transplantation (KNOW-KT)

Session Information

• Transplantation: Cardiovascular and Metabolic Diseases
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 1802 Transplantation: Clinical

Authors

• Han, Seungyeup, Keimyung University School of Medicine, Daegu, Korea (the Republic of)

Seungyeup Han,

• Kang, Seong Sik, Keimyung University School of Medicine, Daegu, Korea (the Republic of)

Seong Sik Kang,

• Park, Hayeon, Keimyung University School of Medicine, Daegu, Korea (the Republic of)

Hayeon Park,

• Paek, Jin hyuk, Keimyung University School of Medicine, Daegu, Korea (the Republic of)

Jin hyuk Paek,

• Yeo, Sang Mok, Keimyung University School of Medicine, Daegu, Korea (the Republic of)

Sang Mok Yeo,

• Park, Woo Yeong, Keimyung University School of Medicine, Daegu, Korea (the Republic of)

Woo Yeong Park,

• Jin, Kyubok, Keimyung University School of Medicine, Daegu, Korea (the Republic of)

Kyubok Jin,

• Park, Sung Bae, Keimyung University School of Medicine, Daegu, Korea (the Republic of)

Sung Bae Park,

Group or Team Name

• KNOW-KT Study Group

Background

Cardiovascular disease (CVD) is a major cause of graft and patient loss in kidney transplant (KT) recipients. Inadequate control of hypertension in KT recipient is associated with an increased risk of CVD. Therefore blood pressure control after KT is important and it is also important to evaluate the related factors. The purpose of this study was to evaluate the incidence and related factors of withdrawing antihypertensive (AH) medication early after KT.

Methods

A total of 1,080 patients were enrolled in KoreaN cohort study for Outcome in patients With Kidney Transplantation (KNOW-KT) between July 2012 and August 2016. The study included 857 recipients who had been treated for hypertension prior to KT and followed-up for 1-year after KT. We evaluated associated factors of withdrawing AH medication within 1-year after KT.

Results

Among 857 the recipients, 278 (32.4%) withdrawn AH medication within 1-year after KT. The medication withdrawn (MW) group was younger than the medication continued (MC) group and the proportion of female, nondiabetic patients, and non-smokers were higher. In the pre-transplant evaluation, the MW group had lower systolic blood pressure (SBP), body mass index (BMI), triglyceride/high density lipoprotein (TG/HDL) ratio, and serum TG levels and showed thinner left ventricular posterior wall thickness (LVPWT) and smaller left atrial diameter in echocardiography. One year after KT, the MW group had lower BMI, TG/HDL ratio, and serum TG levels and had a lower incidence of delayed graft function (DGF), acute rejection (AR), and coronary artery disease (CAD). In multivariate logistic regression analysis, predictors of withdrawing AH medication after KT were female, lower SBP before KT and thin LVPWT in pre-transplant echocardiography.

Conclusion

In a Korean cohort study, 32.4% of recipients who were treated with hypertension before KT stopped AH medication 1-year after KT. For better control of BP and prevention of additional administration of AH medication after KT, it is important not only to prevent DGF, AR, and CAD after KT, but also to control SBP and prevent cardiovascular remodeling before KT.