ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: PO2073

Association Between Early Post-Transplant Hypertension or Related Antihypertensive Use and Prognosis of Kidney Transplant Recipients: A Nationwide Observational Study

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Park, Sehoon, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  • Kim, Yaerim, Keimyung University School of Medicine, Daegu, Daegu, Korea (the Republic of)
  • Kim, Yong Chul, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
  • Kim, Yon Su, Seoul National University Hospital, Jongno-gu, Korea (the Republic of)
  • Lee, Hajeong, Seoul National University Hospital, Jongno-gu, Korea (the Republic of)
Background

Additional research is warranted for the clinical significance of post-transplant hypertension and related antihypertensive medication usage in kidney transplant (KT) recipients.

Methods

This observational study included nationwide KT recipients who maintained functioning graft for at least 1 year after KT in South Korea during 2008 to 2017. The usage of antihypertensive medications between 6 months to 1 year was the main exposure, and those who had inconsistent/transient usage of antihypertensive drugs were excluded. The prognostic outcome included death-censored graft failure (DCGF), death-with functioning graft (DWGF), and major adverse cerebrocardiovascular events (MACCEs).

Results

We included 8014 patients without post-transplant hypertension and 6114 recipients who received treatments for hypertension in the post-transplant period. Those with post-transplant hypertension had significantly worse risk of DCGF than those without [adjusted hazard ratio (HR) 1.27 (1.09-1.48)]. Post-transplant hypertension patients who required multiple drugs showed significantly higher risk of DWGF [HR 1.57 (1.17-2.10)] and MACCE [HR 1.35 (1.01-1.81)] than the controls. Among the single-agent users, those who received beta-blockers showed a significantly higher risk of DCGF, although the risks of DWGF or MACCE were similar between the types of antihypertensive agents. Among the multiple agent users, the prognosis was similar regardless of the prescribed types of antihypertensive agents.

Conclusion

Post-transplant hypertension was associated with poor post-transplant prognosis, particularly when multiple types of medications were required for treatment. During initial prescription of antihypertensive medication, clinicians may consider that beta-blockers were associated with a higher risk of DCGF in the single-agent users.