Hypertension After Kidney Transplant

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Hypertension After Kidney Transplant Mahendra Mangray, MD, John P. Vella, MD, FRCP American Journal of Kidney Diseases Volume 57, Issue 2, Pages 331-341 (February 2011) DOI: 10.1053/j.ajkd.2010.10.048 Copyright © 2011 National Kidney Foundation, Inc. Terms and Conditions

Figure 1 Mortality after kidney transplant. Atherosclerotic disease is the most common cause of death after transplant (44%) and outweighs the contributions from infection and malignancy combined (33%). Abbreviations: CBVD, cerebrovascular disease; CVD, cardiovascular disease. Source: US Renal Data System.3 American Journal of Kidney Diseases 2011 57, 331-341DOI: (10.1053/j.ajkd.2010.10.048) Copyright © 2011 National Kidney Foundation, Inc. Terms and Conditions

Figure 2 Association of hypertension at 1 year with transplant survival. Kidney transplant survival is inversely proportional to blood pressure. Abbreviation: SBP, systolic blood pressure. Reproduced from Opelz et al16 with permission of Nature Publishing Group. American Journal of Kidney Diseases 2011 57, 331-341DOI: (10.1053/j.ajkd.2010.10.048) Copyright © 2011 National Kidney Foundation, Inc. Terms and Conditions

Figure 3 Mechanisms by which hypertension after kidney transplant is mediated. A complex interplay exists resulting from decreased glomerular filtration rate (GFR), vasoconstriction, and sodium retention that are variously adversely affected by immunosuppressive agents. Abbreviation: RAS, renin-angiotensin system. American Journal of Kidney Diseases 2011 57, 331-341DOI: (10.1053/j.ajkd.2010.10.048) Copyright © 2011 National Kidney Foundation, Inc. Terms and Conditions

Figure 4 Kidney function and choice of antihypertensive agent. The achieved glomerular filtration rate (GFR) in patients treated with calcium channel blockers is greater than for those treated with angiotensin-converting enzyme inhibitors (measured at 3 weeks and 1 and 2 years after transplant). Reproduced from Midtvedt & Hartmann68 with permission of the European Renal Association–European Dialysis and Transplant Association. American Journal of Kidney Diseases 2011 57, 331-341DOI: (10.1053/j.ajkd.2010.10.048) Copyright © 2011 National Kidney Foundation, Inc. Terms and Conditions