Hypertension and long-term renal allograft survival:: effect of early glomerular filtration rate

被引:34
作者
Fernández-Fresnedo, G [1 ]
Palomar, R [1 ]
Escallada, R [1 ]
de Francisco, ALM [1 ]
Cotorruelo, JG [1 ]
Zubimendi, JA [1 ]
de Castro, SS [1 ]
Ruiz, JC [1 ]
Rodrigo, E [1 ]
Arias, M [1 ]
机构
[1] Hosp Univ Marques de Valdecilla, Serv Nefrol, Santander 39008, Spain
关键词
creatinine clearance; glomerular filtration rate; hypertension; renal transplantation;
D O I
10.1093/ndt/16.suppl_1.105
中图分类号
R3 [基础医学]; R4 [临床医学];
学科分类号
1001 ; 1002 ; 100602 ;
摘要
Background. For many years, hypertension has been related to long-term survival of patients and kidney grafts, although the nature of this relationship has not been completely defined. The aim of this study was to analyse the influence of early glomerular filtration rate on post-transplant hypertension and on graft survival. Methods. A total of 432 kidney transplanted patients on cyclosporin therapy, with a functioning graft for at least 1 year, were studied. They were divided into two groups depending on their early creatinine clearance: group A [<60 ml/min (n=270)] and group B [ > 60 ml/min (n = 162)]. Results. There were no differences in sex, aetiology of renal failure, number of retransplants, PRA, HLA mismatches and pre-transplant blood pressure. One year after transplantation, blood pressure was higher in group A (systolic BP 148/diastolic BP 86/mean BP 117) than in group B (systolic BP 140/diastolic BP 82/mean BP 111) (P<0.003). We observed a negative correlation between early creatinine clearance and 1-year blood pressure (P<0.01). Five and 10 year graft survival was 60 and 37% in group A and 87 and 69% in group B, respectively (P<0.000). A multivariate Cox analysis showed that 1-year blood pressure (P < 0.0029, RR = 1.76) and early creatinine clearance (P<0.000, RR=3.27) had a significant influence on graft survival. Conclusions. The 1-year post-transplant blood pressure is a non-immunological risk factor in long-term graft survival. Patients with a lower initial glomerular filtration rate are more susceptible to the development of secondary hypertension and worse graft survival.
引用
收藏
页码:105 / 109
页数:5
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