Comparative effectiveness of different antihypertensive agents in kidney transplantation: a systematic review and meta-analysis.

@article{Pisano2019ComparativeEO,
  title={Comparative effectiveness of different antihypertensive agents in kidney transplantation: a systematic review and meta-analysis.},
  author={Anna Rita Pisano and Davide Bolignano and Francesca Romana Mallamaci and Graziella D’Arrigo and Jean-Michel Halimi and Alexandre Persu and Gr{\'e}goire Wuerzner and Pantelis A. Sarafidis and Bruno Watschinger and Michel Burnier and Carmine Zoccali},
  journal={Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association},
  year={2019}
}
  • A. PisanoD. Bolignano C. Zoccali
  • Published 29 May 2019
  • Medicine
  • Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
BACKGROUND We conducted a systematic review and meta-analysis to compare benefits and harms of different antihypertensive drug classes in kidney transplant recipients, as post-transplant hypertension (HTN) associates with increased cardiovascular (CV) morbidity and mortality. METHODS The Ovid-MEDLINE, PubMed and CENTRAL databases were searched for randomized controlled trials (RCTs) comparing all main antihypertensive agents versus placebo/no treatment, routine treatment. RESULTS The search… 

OP-NDTJ190093 1..10

CCBs could be the preferred first-step antihypertensive agents in kidney transplant patients, as they improve graft function and reduce graft loss.

Adverse Effects of Angiotensin-Converting Enzyme Inhibitors in Humans: A Systematic Review and Meta-Analysis of 378 Randomized Controlled Trials

Background: Although angiotensin-converting enzyme (ACE) inhibitors are among the most-prescribed medications in the world, the extent to which they increase the risk of adverse effects remains

Antihypertensive Treatment in Kidney Transplant Recipients—A Current Single Center Experience

In addition to the well-known risk factors of cold ischemic time and acute rejection episodes, the number of antihypertensive drugs after one year, which reflects the severity of hypertension, is a strong predictor of unfavorable allograft survival.

Assessment of hypertension in kidney transplantation by ambulatory blood pressure monitoring: a systematic review and meta-analysis

Comparison of OBP versus ABP measurements disclosed a high proportion of MHT, uncontrolled HTN and, to a lesser extent, WCH in KTRs, suggesting that HTN is not adequately diagnosed and controlled by OBP recordings in this population.

Should ACE inhibitors or calcium channel blockers be used for post-transplant hypertension?

The results of the most current meta-analyses recommend that due to their positive effects on graft function and survival, along with their lack of negative effects on serum potassium, CCBs could be the preferred first-line antihypertensive agent in renal transplant recipients, however, anti Hypertensive therapy should be individually tailored based on other factors.

Blood pressure monitoring in kidney transplantation: a systematic review on hypertension and target organ damage.

  • A. PisanoF. Mallamaci C. Zoccali
  • Medicine
    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
  • 2021
In a systematic review, ABPM reflected target organ damage more closely than oBP in KTRs and identified a group of kidney recipients at risk for kidney function loss and CV abnormalities.

Update on Treatment of Hypertension After Renal Transplantation

Recommendations about BP targets in adult renal transplant recipients are coming from a post hoc analysis of a large randomized trial with another primary endpoint, and unless convincing studies on treatment of hypertension after renal transplantation are available, the ESC/ESH Guidelines 2018 should apply.

Arterial hypertension in kidney transplantation: huge importance, but few answers.

The aim of the present study was to review the issue of hypertension in RTX, addressing its multifactorial pathophysiology and demonstrating the importance of ABPM as a tool for monitoring BP in patients with discrepant blood pressure values.

Hypertension in kidney transplantation: a consensus statement of the ‘hypertension and the kidney’ working group of the European Society of Hypertension

The current transplant guidelines, which recommend only office BP assessments for risk stratification in kidney transplant patients should be reconsidered, given the presence of white-coat hypertension and masked hypertension in this population and the better prediction of adverse outcomes by 24-h ambulatory BP monitoring as indicated in recent systematic reviews.

Role of hypertension in kidney transplant recipients

Based on the relevant guidelines in the general population, lifestyle modifications should probably be applied as the first step of hypertension management in kidney transplant recipients.

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This meta-analysis demonstrated insignificant reduced risks of renal graft loss among renal transplant recipients who received RAS inhibitors, and future studies assessing the potential benefits of RAS inhibitor on allograft survival in specific kidney transplant patient populations are needed.

Renin Angiotensin System Blockade in Kidney Transplantation: A Systematic Review of the Evidence

ACE‐inhibitors and angiotensin receptor blockers (ARB) slow the progression of renal disease in nontransplant patients. A systematic review of randomized trials (n = 21 trials with 1549 patients) was

Renin-Angiotensin System Blockade and Long-term Clinical Outcomes in Kidney Transplant Recipients: A Meta-analysis of Randomized Controlled Trials.

This analysis neither supports nor refutes the hypothesis that RAS blockade improves clinical outcomes in kidney transplant recipients, and clinicians should weigh the risks and benefits of using these medications with their patients on a case-by-case basis.

Randomized prospective study of effects of benazepril in renal transplantation: an analysis of safety and efficacy

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Treatment of Hypertension in Renal Transplant Recipients in Four Independent Cross-Sectional Analyses

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