Pre- and Post-Dialysis BP Predicts Survival after Transplantation

SAN DIEGO—Low diastolic blood pressure (BP) before, and low systolic BP after, hemodialysis sessions are associated with a reduced risk of death following renal transplantation, according to study findings presented at Kidney Week 2012.

The study, led by Miklos Z Molnar, MD, PhD, and Kamyar Kalantar-Zadeh, MD, MPH, PhD, both now affiliated with the University of California-Irvine, included 12,881 former dialysis patients who underwent renal transplantation. Compared with patients who had a pre-dialysis diastolic BP of at least 70 but less than 80 mm Hg, those with a pre-dialysis DBP below 50 and 100 mm Hg or higher had a 26% reduced risk and 3.5 times increased risk of death post-transplant, respectively. Compared with patients who had post-dialysis systolic BP of at least 140 but less than 150 mm Hg, those with a post-dialysis systolic BP below 110 mm Hg or at least 130 but less than 140 had an approximately 30% decreased mortality risk.

The study found no association between pre-transplant BP and delayed graft function, but demonstrated that very low pre-transplant BP is associated with a lower risk of graft loss.

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