Maintaining blood pressure at 110-130 after kidney transplant linked to 53% lower risk of graft dysfunction

A domestic study found that consistently maintaining systolic blood pressure within the 110-130 mmHg range after kidney transplantation was associated with a 53% lower risk of graft dysfunction or loss.

The Korea Disease Control and Prevention Agency’s Korea National Institute of Health, in collaboration with the Korean Society of Nephrology, published a “Kidney Transplant Fact Sheet” on the 21st, detailing the characteristics and long-term outcomes of kidney transplant recipients in Korea.

The fact sheet was based on findings from the KNOW-KT cohort study, which has followed about 1080 kidney transplant recipients in Korea since 2012.

The researchers focused on blood pressure as a way to preserve graft function over the long term. An analysis of 4559 kidney transplant recipients in Korea found that the longer systolic blood pressure remained within the 110-130 mmHg range, the lower the risk of graft dysfunction or loss.

Compared with patients who never maintained the target blood pressure, those who consistently stayed within the target range had a 53% lower risk. A separate analysis of 828 patients found a similar association.

The effect of maintaining target blood pressure on preserving kidney function was more pronounced in high-risk groups, particularly patients who received kidneys from deceased donors or older or female donors, as well as patients with high baseline systolic blood pressure.

The researchers said the findings came from an observational study analyzing the association between blood pressure and graft function, and that patients should consult their health care providers to determine specific blood pressure management goals.

According to the fact sheet, the mean age of kidney transplant recipients in Korea was 45.8 years, and glomerulonephritis was the most common kidney disease before transplantation, accounting for 31% of cases.

Living donors accounted for 82% of donations, far exceeding deceased donors (18%). This contrasts with the U.S., where deceased donors predominate and living donors account for 22.1%.

Post-transplant survival rates among kidney transplant recipients were 99.0% at 1 year, 97.7% at 5 years and 95.5% at 10 years. The leading causes of death were infection (32.5%), cardiovascular disease (13.9%) and cancer (11.6%).

Choi Beom-soon, president of the Korean Society of Nephrology, said, “Ongoing health management after surgery is important for kidney transplant recipients,” adding, “We will work to develop evidence-based management approaches for kidney transplant recipients.”

Kim Won-ho, director of the Korea National Institute of Health’s Division of Chronic Disease Convergence Research, said, “We have presented a target blood pressure management range that may help preserve graft function in clinical practice.”

The fact sheet will be available on the websites of the Korea National Institute of Health and the Korean Society of Nephrology and is expected to be distributed to relevant institutions, including public health centers nationwide.