Hypertension in kidney transplant recipients  

作　　者：Maria-Eleni Alexandrou Charles J Ferro Ioannis Boletis Aikaterini Papagianni Pantelis Sarafidis 

机构地区：[1]Department of Nephrology,Hippokration Hospital,Aristotle University of Thessaloniki,Thessaloniki 54642,Greece [2]Department of Renal Medicine,University Hospitals Birmingham NHS Foundation Trust,Birmingham B152WB,United Kingdom [3]Department of Nephrology,Laiko General Hospital,National and Kapodistrian University,Athens 11527,Greece

出　　处：《World Journal of Transplantation》2022年第8期211-222,共12页世界移植杂志

摘　　要：Kidney transplantation is considered the treatment of choice for end-stage kidney disease patients.However,the residual cardiovascular risk remains significantly higher in kidney transplant recipients(KTRs)than in the general population.Hypertension is highly prevalent in KTRs and represents a major modifiable risk factor associated with adverse cardiovascular outcomes and reduced patient and graft survival.Proper definition of hypertension and recognition of special phenotypes and abnormal diurnal blood pressure(BP)patterns is crucial for adequate BP control.Misclassification by office BP is commonly encountered in these patients,and a high proportion of masked and uncontrolled hypertension,as well as of white-coat hypertension,has been revealed in these patients with the use of ambulatory BP monitoring.The pathophysiology of hypertension in KTRs is multifactorial,involving traditional risk factors,factors related to chronic kidney disease and factors related to the transplantation procedure.In the absence of evidence from large-scale randomized controlled trials in this population,BP targets for hypertension management in KTR have been extrapolated from chronic kidney disease populations.The most recent Kidney Disease Improving Global Outcomes 2021 guidelines recommend lowering BP to less than 130/80 mmHg using standardized BP office measurements.Dihydropyridine calcium channel blockers and angiotensin-converting enzyme inhibitors/angiotensin-II receptor blockers have been established as the preferred first-line agents,on the basis of emphasis placed on their favorable outcomes on graft survival.The aim of this review is to provide previous and recent evidence on prevalence,accurate diagnosis,pathophysiology and treatment of hypertension in KTRs.

关 键 词：HYPERTENSION Kidney transplantation EPIDEMIOLOGY DIAGNOSIS PHYSIOPATHOLOGY THERAPY 

分 类 号：R69[医药卫生—泌尿科学]