Etiology and Pathogenesis of Hypertension following Renal Transplantation

Vol. 42, No. 2, 1986

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Editorial Review

Etiology and Pathogenesis of Hypertension following Renal Transplantation
Wayne C. Waltzer, Steven Turner, Peter Frohnert, Felix T. Rapaport

Departments of Urology and Surgery, State University of New York at Stony Brook, N. Y. and Department of Medicine, Divisions of Hypertension and Nephrology, Mayo Clinic, Rochester, Minn., USA

Address of Corresponding Author

Nephron 1986;42:102-109 (DOI: 10.1159/000183646)

Key Words

Etiology
Pathogenesis
Hypertension following transplantation

Abstract

Hypertension is a common feature of end-stage renal disease (ESRD) and constitutes a major risk factor for accelerated cardiovascular disease and premature death. While a reduction in the incidence and severity of hypertension is one potential benefit of kidney transplantation, hypertension often remains as a problem after transplantation, even in recipients of wellfunctioning allografts. Despite many studies of the underlying etiologic factors, the mechanisms implicated in post-transplant hypertension are still incompletely understood. A number of variables, including status of the diseased native kidneys, steroid therapy, rejection, recurrence of original disease, activation of the renin-angiotensin system, sodium and calcium metabolism, and transplant renal artery stenosis may play a role in the etiology of hypertension after transplantation. Patients with persistent high blood pressure for more than 3 months after transplantation should be thoroughly investigated, with controlled sodium intake so that proper medical or surgical therapy can be implemented. Since sodium restriction, radionuclide renal scanning, renin levels, or responses to saralasin or captopril may not provide a clear index of various possibilities, an accurate differential diagnosis my also require invasive procedures such as arteriography and/or renal biopsy.

Author Contacts

Wayne C. Waltzer, Md, Departments of Urology and Surgery, State University of New York at Stony Brook, New York, NY 11794 (USA)

Article Information

Accepted: May 20, 1985
Published online: December 04, 2008
Number of Print Pages : 8

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