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논문분류	춘계학술대회 초록집
제목	Impact of blood pressure on kidney outcomes after kidney transplantation
저자	kyungwon kim,Youngsu Joo,Beomseok Kim,Jaeseok Yang
출판정보	2022; 2022(1):
키워드
초록	Objectives: Hypertension has a prevalence of 80% in kidney transplantation (KT) patients and is a major risk factor for graft loss and cardiovascular events after KT. However, the optimal target of blood pressure (BP) remains unclear for KT patients. Therefore, we analyzed the association of BP with kidney outcome in KT patients. Methods: This study included 903 KT patients between 2012 and 2015 from the KoreaN Cohort Study for Outcomes in Patients With Kidney Transplantation (KNOW-KT). Patients were divided into three groups according to systolic BP (SBP) 1 year after KT: SBP < 110 mmHg (group 1); 110 mmHg ≤ SBP < 140 mmHg (group 2, reference); and SBP ≥ 140 mmHg (group 3). The primary endpoint was composite kidney outcome of ≥ 50% decrease in eGFR from baseline values or graft loss which defined as requiring maintenance dialysis for more than 3 months or re-transplantation. Results: During a median follow-up of 5.4 years, there were 88 (9.75%) events of ≥ 50% eGFR decline or graft loss. In multivariate Cox regression analysis after adjustment of covariates, lower baseline SBP was associated with higher risk of adverse kidney outcome (hazard ratio (HR), 2.20; 95% confidence interval (CI), 1.16 to 4.18) and higher baseline SBP was also associated with higher risk of adverse kidney outcome (HR, 2.01; 95% CI, 1.04 to 3.86) compared with the well-controlled SBP group. This association was consistent for time-updated Cox regression model, for which the HR for lower SBP was 2.29 (95% CI, 1.02 to 5.13) and for higher SBP was 2.26 (95% CI, 1.24 to 4.10). In addition, similar results were observed in subgroup analysis stratified by age, sex, BMI, and baseline kidney function. Conclusions: There was “U” curve relationship between SBP and composite kidney outcome after kidney transplantation.
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