The selection of a birth control device depends on the degree of hypertension, and the type and degree of underlying kidney disease. Generally, women who have high blood pressure should avoid the birth control pills as these can raise blood pressure. Often hypertension and kidney disease co-exist (cause or effect) and birth control pills for similar reasons should be avoided. If they are used, then blood pressure needs to be monitored and controlled effectively. Transplant patients should not use an IUD. These patients are more likely to get an infection from an IUD because the anti-rejection drugs may lower their ability to fight infection. The diaphragm, sponge and condom are good means of birth control, especially when used with spermicidal creams, foams or jellies.