HYPERTENSION AFTER RENAL TRANSPLANTATION: A Comparison of Cyclosporine and Conventional Immunosuppression1

Chapman, J. R.; Marcen, R.; Arias, M.; Raine, A. E. G.; Dunnill, M. S.; Morris, P. J.

doi:10.1097/00007890-198706000-00018

Cited by 94Renal Transplantation Outcomes and TreatmentsBlood Pressure and Hypertension StudiesRenal and Vascular Pathologies

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HYPERTENSION AFTER RENAL TRANSPLANTATION: A Comparison of Cyclosporine and Conventional Immunosuppression1

Chapman, J. R., Marcen, R., Arias, M., Raine, A. E. G., Dunnill, M. S., Morris, P. J.·1987·Transplantation

DOI 10.1097/00007890-198706000-00018

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Abstract

Hypertension is a common complication after renal transplantation and is associated with increased mortality. Cyclosporine is known to be nephrotoxic and raises blood pressure in recipients of cardiac and bone marrow transplants, but there is conflicting data on the role of cyclosporine after renal transplantation. We have examined this question in patients entered into the second Oxford prospective randomized comparison of short-term cyclosporine treatment alone with conversion to azathioprine and prednisolone at 90 days (CsA group), and conventional therapy with azathioprine and prednisolone throughout (AP group). Blood pressure and antihypertensive medication were similar in the CsA and AP treatment groups during the first 90 days. Following conversion from cyclosporine, mean blood pressure fell from 155/94 to 142/81 within 7 days, and this fall correlated with the change in plasma creatinine over the same period (r = 0.44, P less than 0.05). Blood pressure was subsequently lower in the converted patients than in those treated with AP throughout. Six months after transplantation patients converted from cyclosporine not only had lower blood pressure but also required fewer antihypertensive drugs than AP patients. This study demonstrates that cyclosporine may elevate the blood pressure in recipients of renal transplants. This effect may either be direct or mediated through the effect of cyclosporine on renal function. Administration of corticosteroids during the first three months after transplantation is implicated as a possible cause of persisting high blood pressure.

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Cyclosporine is associated with enhanced renal vasoconstriction leading to volume-dependent (low renin) hypertension.
“Cyclosporine is associated with enhanced renal vasoconstriction leading to volume-dependent (low renin) hypertension.219,220”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [220]

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Cardiac Transplantation
Pietrasik, G. M., Huether, J., & Chen, L. (2009) · Springer eBooks · doi:10.1007/978-1-84882-185-9_10

Authors: Chapman, J. R., Marcen, R., Arias, M., Raine, A. E. G., Dunnill, M. S., & Morris, P. J.
Affiliations: John Radcliffe Hospital (GB)
ORCID: Chapman, J. R.
Arias, M.
Venue: Transplantation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1987-06
Volume: 43
Issue: 6
Pages: 860-864
ISSN: 0041-1337 (ISSN-L)
DOI: 10.1097/00007890-198706000-00018
OpenAlex: W2027650214
Cited by: 93
References: 0
Citations by year: 2023: 1 · 2018: 3 · 2017: 1
FWCI: 11.28
Type: journal article
Language: en
Open access: closed
Locations: Transplantation (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Transplantation › Renal Transplantation Outcomes and Treatments
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Health Sciences › Medicine › Nephrology › Renal and Vascular Pathologies
Keywords: hypertension, kidney transplantation, cyclosporine, cyclosporine nephrotoxicity, blood pressure, azathioprine, prednisolone, corticosteroids, antihypertensive drugs, serum creatinine, immunosuppressive therapy
MeSH terms: Adult, Azathioprine, Blood Pressure, Creatinine, Cyclosporins, Female, Humans, Hypertension, Immunosuppression Therapy, Male, Middle Aged, Kidney Transplantation

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HYPERTENSION AFTER RENAL TRANSPLANTATION: A Comparison of Cyclosporine and Conventional Immunosuppression1

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