The impact of kidney donor profile index on hypertension after kidney transplantation

Cilj istraživanja: Ispitati utjecaj čimbenika vezanih uz darivatelja organa kao što su KDPI, transplantacija desnog bubrega, nepodudarnost u veličini i spolu između darivatelja i primatelja na AH u razdoblju nakon transplantacije bubrega. Nacrt studije: Studija je ustrojena kao presječno istraživanje s historijskim podatcima. Ispitanici i metode: U studiju je uključeno 90 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, a o darivateljima iz baze Eurotransplanta. Rezultati: Medijan dobi primatelja kod transplantacije iznosio je 54 godine (48 ‒ 60 godina). Klirens kreatinina godinu dana nakon transplantacije iznosio je 54 ml/min (39 ‒ 70 ml/min) i nije se značajnije promijenio u razdoblju praćenja od 5,5 godina. AH je imalo 96 % ispitanika prije transplantacije. Nakon medijana od 4 godine praćenja (4 ‒ 6 godina) 92 % bolesnika uzimalo je antihipertenzivnu terapiju, a na kraju praćenja 5,5 godina (3 ‒ 8 godina) njih 100 %. KDPI darivatelja organa iznosio je 52 (40 ‒ 78,5). U razdoblju praćenja 10 % transplantiranih bolesnika imalo je neželjeni kardiovaskularni događaj. KDPI darivatelja organa iznosi 60 (42 ‒ 88) i značajno je viši u onih primatelja koji uzimaju dva ili više antihipertenziva i to u prvom razdoblju praćenja AH-a (P = 0,02). Desni bubreg dobilo je 56 % primatelja. Primatelji koji su dobili desni bubreg imali su darivatelja sa značajno višim KDPI-jem koji je iznosio 70 (44 ‒ 90, P = 0,008) i uzimali su dva ili više antihipertenziva. U 43 % slučajeva darivatelj i primatelj razlikuju se po spolu, međutim ta razlika ne utječe na AH i funkciju bubrega. Nepodudarnost u veličini između darivatelja i primatelja određena pomoću ITM-a nema utjecaja na AH i funkciju transplantiranog bubrega. Zaključak: Bolesnici kojima je transplantiran bubreg više vrijednosti KDPI-ja (> 60) imali su AH koji je zahtijevao uzimanje više različitih antihipertenziva. Nepodudarnost darivatelja u spolu i veličini nije imala utjecaja na AH u poslijetransplantacijskom razdoblju.Aim of the study: to test the influence of factors connected with organ donors like KDPI, right kidney transplant, matching in size and gender between donor and recipient to AH in the period after the transplantation. Description of the study: The study was constructed as a cross–sectional study with historical data. Patients and methods: The study includes 90 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, and the donor data from the Eurotransplant web page. Result: the median value of the recipients was 54 years (48-60 years). The creatinine clearance a year after the transplant was 54 ml/min (39-70 ml/min) and has not significantly changed in the observation period of 5,5 years. 96% of the observed patients had AH before the transplant. After a median of 4 years of observation (4-6 years) 92% of the patients were on antihypertensive therapy, and at the end of the period of 5.5 years (3-8 years) 100% of them. The KDPI of the donors was 52 (40-78.5). In the period of observation 10% of the patients had an unwanted cardiovascular event. The KDPI of the donors is 60 (42-88) and is significantly higher than of those who take 2 or more antihypertensives and all that in the first period of AH observation period (P=0,02). The right kidney was given to 56% of the recipients. The recipients who received the right kidney had a donor with a significantly higher KDPI which was 70(44-90, P=0,008) and took 2 or more antihypertensives. In 43% of the cases the donor and the recipient differ in gender, but the difference does not affect AH and kidney function. The discrepancy in size between donor and recipient determined by the BMI has no influence on AH and the function of the transplanted kidney. Conclusion: The patients who had a transplanted kidney of a higher value KDPI (> 60) had an AH that required taking more antihypertensives. The mismatching of the donors in gender and size had no influence on AH in the post-transplant period