Update on Treatment of Hypertension After Renal Transplantation

Chatzikyrkou C, Schmieder R, Schiffer M (2021)

Publication Type: Journal article, Review article

Publication year: 2021

Journal

Current Hypertension Reports Current Medicine Group

Book Volume: 23

Article Number: 25

Journal Issue: 5

DOI: 10.1007/s11906-021-01151-8

Abstract

Purpose of Review: To incorporate novel findings on pathophysiology and treatment of posttransplant hypertension. Recent Findings: (1) The sodium retaining effects of CNIs are mediated by stimulation of the thiazide-sensitive sodium chloride co-transporter in the distal convoluted tubule and in this regard chlorthalidone was proven to be an effective antihypertensive drug in renal transplantation. (2) Local and not systemic activation of the renin-angiotensin-aldosterone system plays a crucial role in the pathogenesis of posttransplant hypertension. (3) Recent randomized controlled trials failed to prove the presumed superiority of renin-angiotensin blockers in kidney transplantation. (4) Steroid-free and mammalian target of rapamycin-based immunosuppressive drug combinations did not show favorable effects on blood pressure control. (5) In a recent report the risk of non-melanoma skin cancer was higher with thiazide diuretics. But the increased cancer risk in transplant recipients is mainly attributed to comorbidities, such as diabetes and hypertension and of course to the transplantation condition itself or the obligatory application of immunosuppression, and has little to do with the antihypertensive medication Summary: Actual recommendations about BP targets in adult renal transplant recipients are coming from a post hoc analysis of a large randomized trial with another primary endpoint. Unless convincing studies on treatment of hypertension after renal transplantation are available, the ESC/ESH Guidelines 2018 should apply for these patients.

Authors with CRIS profile

Roland Schmieder Professur für Innere Medizin (Nephrologie) Mario Schiffer Lehrstuhl für Innere Medizin IV

Involved external institutions

Universitätsklinikum Magdeburg A.ö.R. DE Germany (DE)

How to cite

APA:

Chatzikyrkou, C., Schmieder, R., & Schiffer, M. (2021). Update on Treatment of Hypertension After Renal Transplantation. Current Hypertension Reports, 23(5). https://doi.org/10.1007/s11906-021-01151-8

MLA:

Chatzikyrkou, Christos, Roland Schmieder, and Mario Schiffer. "Update on Treatment of Hypertension After Renal Transplantation." Current Hypertension Reports 23.5 (2021).

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