Hypertension following renal transplantation. Causative factors and therapeutic implications

Abstract

During a 5 yr period, 21 of 319 renal transplant recipients who were admitted for evaluation of refractory hypertension were studied. For comparison 93 consecutive patients were examined in the renal transplant clinic. Hypertension was noted in 47% of the outpatients, occurred with greater frequency after renal transplantation from cadaveric donors and was associated with a decline in renal function. The 21 inpatients had higher blood pressures and were studied at an earlier stage than their outpatient counterparts. Of the inpatients, 14 had underlying stenosis of their transplant artery and revascularization of the transplanted kidney was possible in these patients. Stenosis of the transplant artery was suggested by the occurrence of severe hypertension during the 1st yr after transplantation, a bruit in the transplant region and increased levels of peripheral plasma renin activity.