Blood Pressure Control According to the Prevalence of Diabetes in Renal Transplant Recipients

Hypertension is one of the most frequent complications of renal transplantation. About 70% to 90% of this population display either high blood pressure (BP) or require antihypertensive therapy. Diabetes mellitus is also a common finding among kidney transplant recipients. The aim of the study was to assess the BP control among kidney transplant recipients according to the prevalence of diabetes. This retrospective analysis included 172 renal transplant recipients of overall mean age 50 years and 51% males. Hypertension was present in 79% of patients. About one-third of the studied population showed abnormal blood pressures based on office measurements. The cohort was divided into two groups according to the presence of diabetes: group 1, diabetic patients (n = 14) versus group 2, nondiabetics (n = 158). Nondiabetic patients were significantly older than diabetic ones (61.5 versus 49 years; P < .05) and their time after renal transplantation was longer (98.83 versus 67.33 months, P < .05). There was no difference in regard to hypertension prevalence, mean BP value, percentage of abnormal (≥ 140/90 mm Hg) BP values or glomerular filtration rate. Diabetic patients were prescribed less steroid. The main hypotensive drug used in whole cohort and in no-diabetic patients was a beta-blocker (n = 64, 37%; n = 4, 28%), patients with diabetes used beta-blockers and angiotensin-converting enzyme inhibitors at the same frequency (n = 60, 37%). The main causative factor for hypertension appeared to be the calcineurin inhibitor. More aggressive antihypertensive treatment using combined drugs, including RAS blockers, might provide adequate BP control among renal transplant subjects with high cardiovascular risk.