TY - JOUR
TI - Hypertension in kidney transplantation: a consensus statement of the
`hypertension and the kidney' working group of the European Society of
Hypertension
AU - Halimi, Jean-Michel
AU - Ortiz, Alberto
AU - Sarafidis, Pantelis A. and
AU - Mallamaci, Francesca
AU - Wuerzner, Gregoire
AU - Pisano, Anna
AU - London,
AU - Gerard
AU - Persu, Alexandre
AU - Rossignol, Patrick
AU - Sautenet,
AU - Benedicte
AU - Ferro, Charles
AU - Boletis, John
AU - Kanaan, Nada and
AU - Vogt, Liffert
AU - Bolignano, Davide
AU - Burnier, Michel
AU - Zoccali,
AU - Carmine
JO - JOURNAL OF HYPERTENSION
PY - 2021
VL - 39
TODO - 8
SP - 1513-1521
PB - Lippincott, Williams & Wilkins
SN - -
TODO - 10.1097/HJH.0000000000002879
TODO - blood pressure; consensus; hypertension; kidney transplantation;
targets; treatment
TODO - Hypertension is common in kidney transplantation recipients and may be
difficult to treat. Factors present before kidney transplantation,
related to the transplantation procedure itself and factors developing
after transplantation may contribute to blood pressure (BP) elevation in
kidney transplant recipients. The present consensus is based on the
results of three recent systematic reviews, the latest guidelines and
the current literature. The current transplant guidelines, which
recommend only office BP assessments for risk stratification in kidney
transplant patients should be reconsidered, given the presence of
white-coat hypertension and masked hypertension in this population and
the better prediction of adverse outcomes by 24-h ambulatory BP
monitoring as indicated in recent systematic reviews. Hypertension is
associated with adverse kidney and cardiovascular outcomes and decreased
survival in kidney transplant recipients. Current evidence suggests
calcium channel blockers could be the preferred first-step
antihypertensive agents in kidney transplant patients, as they improve
graft function and reduce graft loss, whereas no clear benefit is
documented for renin-angiotensin system inhibitor use over conventional
treatment in the current literature. Randomized control trials
demonstrating the clinical benefits of BP lowering on kidney and major
cardiovascular events and recording patient-related outcomes are still
needed. These trials should define optimal BP targets for kidney
transplant recipients. In the absence of kidney transplant-specific
evidence, BP targets in kidney transplant recipients should be similar
to those in the wider chronic kidney disease population.
ER -