Dynamics of the circadian blood pressure profiles after renal transplantation.

摘要: Background. Abnormalities of diurnal blood pressure (BP) rhythm (nondipping) are well-described in dialysis patients, and have prognostic importance. It is controversial whether successful renal transplantation (RTx) improves BP rhythm. To date, no study has attempted to define model the evolution profiles from engraftment, focusing on immediate (4-6 weeks) medium-term (>1 year) postengraftment periods. Methods. test if kidney normalizes profile, ambulatory monitoring (ABPM) was performed 20 living related transplants (age, 30.3 + 5, years; 11 males, for 25.6 months) 1 month preRTx repeated >1 year (ABPM 3 ) after RTx. Dipping defined as a sleep-to-awake ratio >0.92 (for systolic BP) >0.90 diastolic BP). Results. PreRTx only 15% patients were dippers. At postRTx (creatinine clearance, 65.8 ml/min), all complete nondippers. However, 70.4 40% now Most importantly, overall, 30% improved significantly their circadian (35.3% initial nondippers). Despite transplantation, 55% maintained unchanged nondipping profile throughout three ABPM recordings. The determinants long-term contemporary level function baseline, dipping profile: SBP with serum creatinine (r=0.58, P=0.001), clearance (r = -0.41, P=0.036) SBP, (r=0.48, P=0.034); similarly DBP (r=0.63, -0.471, (r=0.53, P=0.016). In all, 57% variance status can be attributed explained by contribution variability. Conclusions. Half nondipper maintain permanently abnormal rhythm, despite short term, RTx associated highly exclusively ciclosporin dose levels. longer leads significant improvement influenced pretransplantation profile.