文章基本信息

标题：Intensive blood pressure control is associated with improved patient and graft survival after renal transplantation
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作者：Nikolaos Pagonas ; Frederic Bauer ; Felix S. Seibert 等
期刊名称：Scientific Reports
电子版ISSN：2045-2322
出版年度：2019
卷号：9
期号：1
页码：1-7
DOI：10.1038/s41598-019-46991-2
出版社：Springer Nature
摘要：Based on data of the SPRINT trial, American hypertension guidelines recently reduced the blood pressure goal from 140/90 mmHg to 130/80 mmHg for subjects with chronic kidney disease (CKD), whereas European guidelines recommend a systolic blood pressure (SBP) of 130-139 mmHg. The present analysis investigates whether a SBP < 130 mmHg is associated with an additional benefit in renal transplant recipients. We performed a retrospective analysis of 815 renal transplant recipients who were stratified according to mean office SBP values < 130 mmHg, 130-139 mmHg or ≥140 mmHg. Patient and graft survival was defined as composite endpoint, follow-up was limited to 120 months. Mean SBP of the follow-up was significantly associated with the composite endpoint (n = 218) with better survival for a SBP < 130 mmHg and 130-139 mmHg compared to ≥140 mmHg (p < 0.001). The differences in the combined endpoint remained significant in Cox regression analysis adjusted for age, gender and eGFR (p = 0.007, HR = 0.58, 95%CI = 0.41-0.53), but not for graft survival alone. Renal transplant recipients with SBP < 130 mmHg had a lower mortality than those with the conservative blood pressure goal <140 mmHg. These data suggest that the new AHA BP targets are safe for renal transplant recipients and - with all limitations of a retrospective analysis - might even be associated with improved outcome.