Hypertension may be transplanted with the kidney in humans: A long-term historical prospective follow-up of recipients grafted with kidneys coming from donors with or without hypertension in their families

E. Guidi, D. Menghetti, S. Milani, G. Montagnino, P. Palazzi, G. Bianchi

Research output: Contribution to journalArticle

Abstract

In several genetic hypertensive rat strains, transplantation studies have established that the kidney carries at least a portion of the genetic message for hypertension. In man it has, of course, been more difficult to obtain clearcut results. This historical prospective observational study, double-blinded for knowledge of donors' and recipients' familiarities for hypertension, concerns 85 transplanted patients, not treated with cyclosporine and with stable renal function, followed up for an average of 8 yr. Both the donors' and the recipients' families were carefully characterized for presence or absence of hypertension. After transplantation, in recipients without hypertension in their own families, a kidney coming from a 'hypertensive' family determines less withdrawal and more introduction of antihypertensive therapy (AHT) than a kidney from a 'normotensive' family (odds ratio for AHT introduction 5.0, confidence interval, 1.4 to 17.8; P = 0.017). In recipients with familial hypertension, the origin of the kidney does not influence the prevalence of hypertension after transplantation. More detailed analyses show that, in recipients without familial hypertension, the transplantation of a 'hypertensive' kidney determines a tenfold larger increase in the requirement of antihypertensive therapy than the transplantation of a 'normotensive' kidney, to obtain a similar blood pressure control (P = 0.003). This result is confirmed by the analysis of time-profile trends for antihypertensive therapy, adjusted for missing data, in the most clinically stable period (2nd to 10th yr after transplantation). The transmission of familial hypertension with the kidney is thus seen only in recipients coming from 'normotensive' families, because familiarity for hypertension blunts the effect of a 'hypertensive' kidney.

Original languageEnglish
Pages (from-to)1131-1138
Number of pages8
JournalJournal of the American Society of Nephrology
Volume7
Issue number8
Publication statusPublished - 1996

Keywords

  • Familiarity for hypertension
  • Genetics of hypertension
  • Kidney donors
  • Kidney transplantation
  • Post-transplantation hypertension

ASJC Scopus subject areas

  • Nephrology

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