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

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11140%2F21%3A10410816" target="_blank" >RIV/00216208:11140/21:10410816 - isvavai.cz</a>

Alternative codes found

RIV/00064203:_____/21:10410816 RIV/00216208:11130/21:10410816

Result on the web

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=ef3AMRYeFa" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=ef3AMRYeFa</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1007/s00467-020-04485-8" target="_blank" >10.1007/s00467-020-04485-8</a>

Result language

angličtina

Original language name

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

Original language description

Arterial hypertension in renal transplant recipients warrants antihypertensive treatment. The preferable choice of antihypertensives that should be used in patients after kidney transplantation remains a matter of debate; however, calcium channel blockers (CCB) and angiotensin-converting enzyme inhibitors (ACEI) are currently the most commonly used antihypertensives. This educational review summarizes the current evidence about the effects of these two classes of medications in transplant recipients. Several studies have demonstrated that both classes of drugs can reduce blood pressure (BP) to similar extents. Meta-analyses of adult randomized controlled trials have shown that graft survival is improved in patients treated with ACEIs and CCBs, and that CCBs increase, yet ACEIs decrease, graft function. Proteinuria is usually decreased by ACEIs but remains unchanged with CCBs. In children, no randomized controlled study has ever been performed to compare BP or graft survival between CCBs and ACEIs. Post-transplant proteinuria could be reduced in children along with BP by ACEIs. 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, antihypertensive therapy should be individually tailored based on other factors, such as time after transplantation, presence of proteinuria/albuminuria, or hyperkalemia. Furthermore, due to the difficulty in controlling hypertension, combination therapy containing both CCBs and ACEIs could be a reasonable first-step therapy in treating children with severe post-transplantation hypertension.

Czech name

—

Czech description

—

Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30209 - Paediatrics

Project

<a href="/en/project/LO1503" target="_blank" >LO1503: BIOMEDIC</a><br>

Continuities

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)

Publication year

2021

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Pediatric Nephrology

ISSN

0931-041X

e-ISSN

—

Volume of the periodical

36

Issue of the periodical within the volume

3

Country of publishing house

DE - GERMANY

Number of pages

11

Pages from-to

539-549

UT code for WoS article

000516198000002

EID of the result in the Scopus database

2-s2.0-85079481078