AUTHOR=Kim Hyo Jeong , Kim Kyung Won , Joo Young Su , Ryu Junghwa , Jung Hee-Yeon , Jeong Kyung Hwan , Kim Myung-Gyu , Ju Man Ki , Han Seungyeup , Lee Jong Soo , Kang Kyung Pyo , Ro Han , Lee Kyo Won , Huh Kyu Ha , Kim Myoung Soo , Kim Beom Seok , Yang Jaeseok TITLE=Impact of Blood Pressure on Allograft Function and Survival in Kidney Transplant Recipients JOURNAL=Transplant International VOLUME=37 YEAR=2024 URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2024.12574 DOI=10.3389/ti.2024.12574 ISSN=1432-2277 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.