REN and Hypertension: Hypertension is commonly observed post transplantation and CNI are important contributors to post transplantation hypertension, which is often characterized by a low renin and aldosterone state.2 Ishani et al. demonstrated that diastolic blood pressure elevation is an independent predictor of progressive kidney disease after lung and heart-lung transplantation.26 This observation is consistent with those in nontransplant patients.