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Chronic Allograft Nephropathy (CAN) is one of the most common cause of kidney transplant loss. The pathogenesis of CAN is complex and incompletely understood, and involves several immunological and non-immunological factors. Here, we talk about the relationship between hypertension and CAN.
1. Hypertension is a risk factor for Chronic Allograft Nephropathy.
For long time, it has been known that high blood pressure is associated with graft failure. High blood pressure of the recipient is one of the non-immunological causes of CAN. The graft survival was significantly inferior in hypertensive patients.
2. Is hypertension the cause or consequence of CAN?
The association between high blood pressure and deterioration of kidney function isn't proved to be a causal relationship. Hypertension after kidney transplant may simply be the result of graft function deterioration rather than vice versa. Studies can not differentiate between cause and effect of the relationship between high blood pressure after transplant and graft survival.
The first evidence that hypertension per se may result in graft damage was the observation that not only elevated blood pressure after kidney transplant, but also increased blood pressure before transplantation is related with later CAN. In the latter cases, the risk can be icnreased by a factor of 3.4, the magnitude which was only surpassed by late (>60 days after transplantation) acute rejection episodes, which increased the risk by 5.5. Studies in animals also support the concept of hypertension-induced graft damage.
Recognizing the association between hypertension and CAN can help patients better deal with their conditions. Is there still anything unclear? You can leave us a message or contact our online family doctor.