Lower blood pressure (BP) targets recommended in recent guidelines for patients with chronic kidney disease (CKD) are safe for renal transplant recipients and may be associated with improved survival, according to investigators.
In a retrospective study of 815 renal transplant recipients, Timm H. Westhoff, MD, of Ruhr-University of Bochum in Bochum, German, and colleagues found that patients who had a mean systolic BP (SBP) below 130 mm Hg had a significant 42% decreased risk of a composite end point of patient and graft survival and 47% decreased risk of death alone compared with those who had a mean SBP of 140 mm Hg or higher (reference) in adjusted analyses. Recipients with a mean SBP of 130 to 139 mm Hg experienced a nonsignificant improvement in the composite end point and in graft survival.
Based on data from the SPRINT trial, the American Heart Association published updated guidelines in 2017 recommending that the BP goal in patients with CKD be reduced from 140/90 to 130/80 mm Hg. In 2018, the European Society of Hypertension published guidelines recommending a systolic pressure of 130 to 139 mm Hg and diastolic pressure below 80 mm Hg for patients with CKD.
“These data suggest that the new BP targets are safe for renal transplant recipients and—with all limitations of a retrospective analysis—might even be associated with improved outcome,” Dr Westhoff and colleagues concluded in Scientific Reports.
Study patients had a mean age of 50 years at the time of transplantation. During a median follow-up duration of 83.5 months, 118 patients returned to dialysis and 110 died.
Pagonas N, Bauer F, Seibert FS, et al. Intensive blood pressure control is associated with improved patient and graft survival after renal transplantation. Sci Rep. 2019;9:10507.