1. Impact of Blood Pressure on Allograft Function and Survival in Kidney Transplant Recipients.
- Author
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Kim HJ, Kim KW, Joo YS, Ryu J, Jung HY, Jeong KH, Kim MG, Ju MK, Han S, Lee JS, Kang KP, Ro H, Lee KW, Huh KH, Kim MS, Kim BS, and Yang J
- Subjects
- Humans, Female, Male, Middle Aged, Adult, Allografts, Aged, Proportional Hazards Models, Graft Rejection, Transplant Recipients, Hypertension, Kidney Transplantation, Blood Pressure, Graft Survival, Glomerular Filtration Rate
- Abstract
The optimal target blood pressure for kidney transplant (KT) patients remains unclear. We included 808 KT patients from the KNOW-KT as a discovery set, and 1,294 KT patients from the KOTRY as a validation set. The main exposures were baseline systolic blood pressure (SBP) at 1 year after KT and time-varying SBP. Patients were classified into five groups: SBP <110; 110-119; 120-129; 130-139; and ≥140 mmHg. SBP trajectories were classified into decreasing, stable, and increasing groups. Primary outcome was composite kidney outcome of ≥50% decrease in eGFR or death-censored graft loss. Compared with the 110-119 mmHg group, both the lowest (adjusted hazard ratio [aHR], 2.43) and the highest SBP (aHR, 2.25) were associated with a higher risk of composite kidney outcome. In time-varying model, also the lowest (aHR, 3.02) and the highest SBP (aHR, 3.60) were associated with a higher risk. In the trajectory model, an increasing SBP trajectory was associated with a higher risk than a stable SBP trajectory (aHR, 2.26). This associations were consistent in the validation set. In conclusion, SBP ≥140 mmHg and an increasing SBP trajectory were associated with a higher risk of allograft dysfunction and failure in KT patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Kim, Kim, Joo, Ryu, Jung, Jeong, Kim, Ju, Han, Lee, Kang, Ro, Lee, Huh, Kim, Kim and Yang.)
- Published
- 2024
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