Donor and recipient family histories of hypertension influence renal impairment and blood pressure during acute rejections

Abstract

A previous historical prospective observational study, double blinded for knowledge of kidney donors' family history of hypertension, included 85 transplanted patients with stable renal function, not treated with cyclosporine, who were followed-up for an average of 8 yr and carefully characterized for the presence or absence of hypertension in the donor and recipient families. The recipients without a family history of hypertension, but grafted with a kidney coming from a 'hypertensive' family, developed hypertension much more frequently than recipients grafted with a kidney coming from a 'normotensive' family, or recipients with familial hypertension in whom the origin of the kidney did not influence the prevalence of hypertension after transplantation. In this second study of the same patients, it was found that these recipients with a 'normotensive' family and a 'hypertensive' kidney showed a greater increase of diastolic BP (P = 0.005) and a greater degree of acute renal damage (P = 0.004) during acute rejections than all of the other recipients. This extension study shows that a grafted kidney can transmit not only chronic hypertension, but also susceptibility to a greater rise in BP and more severe kidney impairment after an acute insult.