Hypertension in Related Living Donor Renal Allograft Recipients

Cardiovascular morbidity and mortality are extremely high in all stages of renal failure. Arterial hypertension remains a major problem even after renal transplantation. We studied retrospectively the hypertension patterns in recipients of renal allografts from living donors from January 1998 to December 2004. The mean age of the patients was 29.3 ± 9.4 (range 13 - 54) years, with a male predominance (62%). Among 42 of the study patients, 40 (95%) were hypertensive at 3 months after transplantation with a slightly decreasing prevalence at 6 and 12 months to 84% and 85%, respectively. During dialysis period, 59.5% of the patients were hypertensive. The allografts were left kidneys with only one artery in 40 patients and right kidneys with 2 arteries in 2 patients. Graft renal artery stenosis (RAS) was documented by Doppler ultrasound in 13 (32.5%) cases. Three patients improved following transluminal angioplasty with stenting. The control of the hypertension required the use of at least two anti-hypertensive drugs in 56% of patients. On an average follow-up of 30 (1 - 78) months, no cardio-vascular event was reported and all the allografts remained functional. We conclude that hypertension is prevalent in the living renal allografts recipients. The etiology is multifactorial and careful management is mandatory to protect the renal function and the cardiovascular system