Hypertension after kidney transplantation and risk factors linked to the organ receipent

Cilj istraživanja : Cilj je istraživanja odrediti prevalenciju arterijske hipertenzije nakon transplantacije bubrega, utvrditi funkciju transplantiranog bubrega izračunavajući klirens kreatinina pomoću CKD-EPI formule te ispitati utjecaj imunosupresivne terapije na arterijsku hipertenziju nakon transplantacije bubrega. Nacrt istraživanja : Studija je ustrojena kao presječno istraživanje s povijesnim podatcima. Ispitanici i postupci : U studiju je uključeno 80 bolesnika koji su transplantirani u KBC-u Osijek i redovito se kontroliraju u nefrološkoj ambulanti Zavoda za nefrologiju. Podatci o primateljima prikupljeni su iz njihovih povijesti bolesti. Rezultati : Medijan dobi primatelja kod transplantacije iznosio je 53 godine (47 ‒ 60 godina). Klirens kreatinina godinu dana nakon transplantacije iznosio je 54 ml/min (39,5 ‒ 68 ml/min) i nije se značajnije promijenio u razdoblju praćenja. AH je imalo 95 % ispitanika prije transplantacije. Nakon medijana od 4 godine praćenja (1,5 ‒ 6 godina) 91 % bolesnika uzimalo je antihipertenzivnu terapiju, a na kraju praćenja 5 godina (3 ‒ 7 godina) njih 100 %. U prvom mjerenju značajno više bolesnika, njih 47 %, koji uzimaju prednizon uzima dva ili više antihipertenziva. U razdoblju praćenja 11 % bolesnika imalo je kardiovaskularni događaj. Preko dvije trećine bolesnika imalo je glomerulonefritis, dijabetičku nefropatiju ili hipertenzivnu bolest bubrega kao osnovnu bubrežnu bolest. Nema značajnih razlika u vrijednosti doza i koncentracija imunosupresiva u odnosu na broj antihipertenzivnih lijekova. AV fistulu ima u 1. mjerenju 29% bolesnika, bez značajne razlike u odnosu na to koliko uzimaju antihipertenziva. Stenozu bubrežne arterije ima 6 % bolesnika. Zaključak : Prevalencija AH-a u transplantiranih bolesnika vrlo je visoka. Svi pacijenti nakon transplantacije koriste barem jedan antihipertenziv, a velika većina koristi dva ili više lijeka. Uporaba glukokortikoida prednizona povezana je s korištenjem dvaju ili više antihipertenziva u velikoj većini bolesnika. Očuvana je bubrežna funkcija u velikog broja bolesnika u vremenu praćenja nakon transplantacije presatka.Aim of the study : The aim of this study was to determine the prevalence of arterial hypertension after kidney transplantation, to determine the function of transplanted kidney by calculating creatinine clearance using CKD-EPI formula and to examine the effect of immunosuppressive therapy on arterial hypertension after kidney transplantation. Description of the study: The study was constructed as a cross – sectional study with historical data. Patients and methods: The study includes 80 patients who have been transplanted at the Osijek UHC and are regularly treated in the nephrology unit of the Nephrology department. The data of the recipients was collected from their disease history. Results : The median age of the transplant recipient was 53 years (47 - 60 years). Creatinine clearance one year after transplantation was 54 ml/min (39.5 - 68 ml/min) and did not change significantly during follow-up period. 95 % of subjects had AH before transplantation. After a median of 4 years of follow-up (1.5 - 6 years), 91 % of patients took antihypertensive therapy, and at the end of follow - up 5 years (3 - 7 years) 100 % of them. In the first measurement significantly more patients, 47 % of them taking prednisone take two or more antihypertensives. At follow - up, 11 % of patients had a cardiovascular event. Over two-thirds of patients had glomerulonephritis, diabetic nephropathy, or hypertensive kidney disease as the underlying kidney disease. There are no significant differences in the values of doses and concentrations of immunosuppressants in relation to the number of antihypertensive drugs. In the 1st measurement, 29 % of patients have AV fistula, without a significant difference in relation to how many antihypertensives they take. Renal artery stenosis is present in 6 % of patients. Conclusion: The prevalence of AH in transplant patients is very high. All patients use at least one antihypertensive agent after transplantation and the vast majority use two or more drugs. The use of the glucocorticoid prednisone has been associated with the use of two or more antihypertensives in a large number of patients. Renal function was preserved in a large number of patients at the time of follow - up after graft transplantation