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Abstract: FR-OR67

Uncontrolled Hypertension Is Associated with Increased Risk of Graft Failure in Kidney Transplant Recipients: A Nationwide Population-Based Study

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Kim, Chang Seong, Chonnam National University Medical School, Gwangju, Gwangju, Korea (the Republic of)
  • Kim, Minah, Chonnam National University Hwasun Hospital, Hwasun-gun, Jeollanam-do, Korea (the Republic of)
  • Suh, Sang Heon, Chonnam National University Medical School, Gwangju, Gwangju, Korea (the Republic of)
  • Choi, Hong Sang, Chonnam National University Medical School, Gwangju, Gwangju, Korea (the Republic of)
  • Bae, Eun Hui, Chonnam National University Medical School, Gwangju, Gwangju, Korea (the Republic of)
  • Ma, Seong Kwon, Chonnam National University Medical School, Gwangju, Gwangju, Korea (the Republic of)
  • Kim, Soo Wan, Chonnam National University Medical School, Gwangju, Gwangju, Korea (the Republic of)
Background

Hypertension is highly prevalent in patients with kidney transplantation caused by transplantation-related immunologic or non-immunologic risk factors. However, whether a strict definition of hypertension (≥130/80 mmHg) and subdivided blood pressure (BP) groups are associated with an increased risk of graft failure after kidney transplantation using a nationwide large cohort study are still unknown.

Methods

Using Korena National Health Insurance Service data, we included 14,249 patients who underwent kidney transplantation from 2002 to 2016. Patients were categorized into five BP groups according to the 2021 Kidney Disease: Improving Global Outcomes practice guidelines for BP management: normal BP (<120/80 mmHg), elevated BP (120–129/<80 mmHg), incident hypertension (≥130/80 mmHg), and controlled or uncontrolled hypertension with anti-hypertensive medications.

Results

The primary outcome was graft failure, which occurred in 1,934 (13.6%) participants during the 6-year follow-up. After adjusting for covariates, hypertension was associated with a higher risk of graft failure [Adjusted hazard ratio (AHR), 1.70; 95% confidence interval (CI), 1.48–1.96)] than no-hypertension. The AHR for graft failure was the highest in patients with uncontrolled hypertension (AHR, 2.13; 95% CI, 1.80–2.52). The risk of graft failure had a linear relationship with systolic and diastolic BP, and pulse pressure.

Conclusion

In this nationwide population-based study, hypertension ≥ 130/80 mmHg based on the 2021 KDIGO BP guidelines in kidney transplantion recipients, and elevated systolic and diastolic BP, and pulse pressure were associated with the risk of developing graft failure in kidney transplant recipients.