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Nephrol Dial Transplant (2002) 17: 25-26
© 2002 European Renal Association-European Dialysis and Transplant Association

IV.5.2 Arterial hypertension

Guidelines

A. Arterial hypertension is often present after renal transplantation and is of multifactorial origin. Pre-transplant arterial hypertension, chronic allograft nephropathy and immunosuppressive therapy are the most frequent causes of post-transplant arterial hypertension. Careful monitoring and treatment of high blood pressure are recommended following transplantation.

(Evidence level B)

B. Post-transplant arterial hypertension is associated with an increased incidence of cardiovascular disease in renal transplant patients and is an independent risk factor for graft failure. Therefore, blood pressure control (<130/85 mmHg for renal transplant recipients without proteinuria, and <125/75 mmHg for proteinuric patients) is mandatory in these patients. General measures and pharmacological intervention are necessary in many cases. In proteinuric patients, anti-hypertensive and anti-proteinuric agents could be used, and stricter blood pressure control is recommended.

(Evidence level C)

C. In patients with uncontrolled arterial hypertension and/or renal function deterioration, underlying causes should be excluded, especially transplant renal artery stenosis.

(Evidence level C)


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