Post Transplant Blood Pressures: Mother to a Transplant Recipient Perspective {Series}

IROC’s mission is to partner with patients with kidney disease and their caregivers to achieve health, longevity and quality of life equivalent to the general population. To start, IROC committed to improving blood pressure control within this group. As part of an ongoing conversation, our community members reflect on blood pressure control and how it impacts their family.

Mother to a Transplant Recipient

Blood pressure became a concern in our lives about 4 years before transplant. That night was quite a surprise as we were called by the on-call nephrologist with some lab values that were abnormal enough to require a visit to the emergency department at 11pm. That visit with abnormal electrolytes and an elevated blood pressure was an indicator of decreasing renal function and was quite scary. Thankfully, with the awesome care of our renal team the blood pressure was controlled and side effects of medications dealt with fairly easily. Blood pressure continued to be something we were aware of as we journeyed toward kidney transplant but it was something that was not an acute issue for us.

Transplant happened and all of the blood pressures normalized and all the blood pressure medications disappeared from the medication list. We thought hypertension was in our past. Post-transplant all of the home measurements and in clinic measurements were well within the range that our transplant team was looking for. At a clinic visit about 2 years ago one of physicians mentioned the transplant team was starting to use 24 hour ambulatory blood pressure monitoring. The idea of wearing the monitor for 24 hours was not appealing to a teenage boy! The ABPM was completed and we received the results.

Much to our surprise, we found out blood pressure medication was going to reenter our lives. The APBM showed that the night time blood pressures were not in range and if not treated could lead to all of the consequences that come with hypertension. The need for BP medication was quite a shock and caused many emotions. Hypertension pre-transplant had been related to decreasing renal function and health so what did this post-transplant hypertension mean? As we have continued to evaluate and manage the blood pressure we are learning this is a manageable issue with proper care but it still leaves us with so many questions on how often we should be checking blood pressure, how do we check blood pressure, what else should we be doing beside taking medication, and how do we really know if nighttime hypertension is controlled?

We are so thankful to work with a team that measures blood pressure in this manner but we were really unaware of the prevalence of post-transplant hypertension and the potential consequences.