Blood Pressure Treatment in Kidney Transplant Recipients-Can We Improve?

Overview

Journal Transplant Direct

Publisher Wolters Kluwer

Specialty General Surgery

Date 2021 Mar 31

PMID 33786373

Authors

Mari O Onsoien

Karsten Midtvedt

Anna V Reisaeter

Knut Aasarod

Bard Waldum-Grevbo

Bjorn Egil Vikse

Bjorn Odvar Eriksen

Anders Asberg

Affiliations

Soon will be listed here.

Abstract

Methods: In conjunction with the 2018 annual data reporting, additional questions were added for recipients with BP >130/80 mm Hg (treating physician´s target BP for each patient, reasons for not achieving target, method of measurement).

Results: Annual forms were received from 98% (3407 of 3486) of KTx recipients, with 1787 (52%) reporting a BP >130/80 mm Hg ("above-target" group). These recipients were older, mostly male, with higher body mass index and serum creatinine levels ( < 0.05) compared with patients with controlled hypertension ("on-target" group). Valid survey answers were available for 84% of the "above-target" group (Surv) with no significant demographic differences versus nonresponders (Surv). Among Surv, 32% were under antihypertensive dose titration, whereas dose-limiting side effects were reported in 7%. Target BP was confirmed to 130/80 mm Hg for 60% of Surv. In recipients for whom the treating physician set target BP >130/80 mm Hg, 51% did not reach these individual targets. The number of antihypertensive drugs was significantly higher in the "above-target" group versus "on-target" group (mean 2.1 ± 1.2 versus 1.8 ± 1.3) and 36% versus 25% used ≥3 antihypertensive drugs ( < 0.05). Automatic attended BP measurement was utilized by 51%.

Conclusions: In KTx recipients, a higher BP target achievement seems possible, potentially in the range of 75%-80%.

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