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Ilona Kurnatowska, Jerzy Królikowski, Kinga Jesionowska, Anna Marczak, Joanna Krajewska, Zbigniew Zbróg, Michał Nowicki
Ann Transplant 2012; 17(1): 50-57
Background: There are limitations of the use of several classes of antihypertensive drugs in patients after kidney transplantation (KTx), as well as contradictory opinions on their effects on progression of graft dysfunction. In this study we assessed the prevalence of arterial hypertension (HA) and the antihypertensive agents used by the patients long after KTx.
Material/Methods: This retrospective evaluation of the number and classes of antihypertensive drugs was based on medical records of 348 patients (140 F, 208 M; mean age 49±13 years) late after KTx (mean time after KTx 78±43 months). The data were related to graft function.
Results: Ninety-three percent of patients after KTx required antihypertensive therapy. Only 8.7% were treated with 1 agent (mean eGFR 65.1±27.4 ml/min), 26.3% received 2 drugs (eGFR 60.0±25.8 ml/min), 34.2% received 3 drugs (eGFR 55.5±23.4 ml/min), 20.1% received 4 drugs (eGFR 54.9±24.9 ml/min), and 10.5% received ≥5 drugs (eGFR 45.9±22.0 ml/min). The number of antihypertensive medications increased along with the deterioration of graft function. Dihydropyridine calcium antagonists (CCB) were the most common class of drugs recommended to the patients after KTx (81%), followed by β-adrenergic antagonists (74.4%); α-antagonists (40.2%), angiotensin-converting enzyme inhibitors (38.7%), diuretics (34.1%), clonidine (17.8%) and angiotensin II receptor blockers (9.5%).
Conclusions: HA is highly prevalent in KTx patients. Multidrug therapy is usually required for the treatment of HA in this population. Dihydropyridine CCB is the most common class of antihypertensive drugs used by them. Graft function is a determining factor in the number of antihypertensive agents.