DONOR AND RECIPIENT FAMILY HISTORIES OF HYPERTENSION INFLUENCE RENAL IMPAIRMENT AND BLOOD-PRESSURE DURING ACUTE REJECTIONS

A previous historical prospective observational study, double blinded for knowledge of kidney donors' family history of hypertension, includ ed 85 transplanted patients with stable renal function, not treated wi th cyclosporine, who were followed-up for an average of 8 yr and caref ully characterized for the presence or absence of hypertension in the donor and recipient families. The recipients without a family history of hypertension, but grafted with a kidney coming from a ''hypertensiv e'' family, developed hypertension much more frequently than recipient s grafted with a kidney coming from a ''normotensive'' family, or reci pients with familial hypertension in whom the origin of the kidney did not influence the prevalence of hypertension after transplantation. I n this second study of the same patients, it was found that these reci pients with a ''normotensive'' family and a ''hypertensive'' kidney sh owed a greater increase of diastolic BP (P = 0.005) and a greater degr ee of acute renal damage (P = 0.004) during acute rejections than all of the other recipients. This extension study shows that a grafted kid ney can transmit not only chronic hypertension, but also susceptibilit y to a greater rise in BP and more severe kidney impairment after an a cute insult.