Ambulatory blood pressure monitoring in renal transplant patients: should it be routinely performed?

作者: S. Beltrán , J. Crespo , J. Kanter , B. Alemany , E. Gavela

DOI: 10.1016/J.TRANSPROCEED.2010.07.064

关键词:

摘要: Abstract Introduction Arterial hypertension is common among kidney transplant patients. It increases cardiovascular risk and a factor for progression of renal failure. Our objective was to perform ambulatory blood pressure monitoring (ABPM) in patients with office hypertension. Methods Patients were divided into 2 groups according their mean ABPM pressures treatment: well-controlled (blood [BP] 130/85 mmHg). A “nondipper pattern” defined as decrease 140/90 mmHg hypertensive documented by ABPM. Results performed 53 patients: 25 (47%) “well-controlled hypertensives” 28 (53%) “poorly controlled hypertensives.” Of the latter, 24 (85%) showed nondipper or raiser pattern only 4 revealing dipper patterns. We compared poorly hypertensives. The latter cohort older (54.4 ± 9.3 vs 45.5 13.8 years; P = .009), received grafts from donors (56.7 15.0 45.8 17 .02); had worse function measured serum creatinine (1.7 0.5 1.4 0.4 mg/dL, .03) Modification Diet Renal Disease (MDRD) formula (41.8 14.0 55.4 20.5 mL/min/1.73 m ; displayed more proteinuria (0.30 0.33 0.18 0.10 g/d, .08). Nondipper higher body mass index (27.1 21.7 kg/m .04). Among patients, 11 presented “white coat phenomenon.” Conclusion observed an important coat” effect, large prevalence uncontrolled nocturnal hypertension, small but incident “masked hypertension.” Factors related control patient age, donor function, induction use, proteinuria.

参考文章(15)
Marco Amidone, Davide Rolla, Giuseppe Cannella, Ernesto Paoletti, Diego Bellino, Relationship between arterial hypertension and renal damage in chronic kidney disease: insights from ABPM. Journal of Nephrology. ,vol. 19, pp. 778- 782 ,(2006)
Gerhard Opelz, Bernd Dohler, , Improved long-term outcomes after renal transplantation associated with blood pressure control. American Journal of Transplantation. ,vol. 5, pp. 2725- 2731 ,(2005) , 10.1111/J.1600-6143.2005.01093.X
Aud-E. Stenehjem, Helga Gudmundsdottir, Ingrid Os, Office blood pressure measurements overestimate blood pressure control in renal transplant patients. Blood Pressure Monitoring. ,vol. 11, pp. 125- 133 ,(2006) , 10.1097/01.MBP.0000209080.24870.2D
Ernesto Paoletti, Maurizio Gherzi, Marco Amidone, Fabio Massarino, Giuseppe Cannella, Association of arterial hypertension with renal target organ damage in kidney transplant recipients: the predictive role of ambulatory blood pressure monitoring. Transplantation. ,vol. 87, pp. 1864- 1869 ,(2009) , 10.1097/TP.0B013E3181A76775
Kevin C. Mange, Arterial hypertension and renal allograft survival. JAMA. ,vol. 283, pp. 633- 638 ,(2000) , 10.1001/JAMA.283.5.633
Bertram L. Kasiske, Shakeel Anjum, Rajiv Shah, Jeffrey Skogen, Chitra Kandaswamy, Barbara Danielson, Eileen A. O’Shaughnessy, David C. Dahl, John R. Silkensen, Meena Sahadevan, Jon J. Snyder, Hypertension after kidney transplantation American Journal of Kidney Diseases. ,vol. 43, pp. 1071- 1081 ,(2004) , 10.1053/J.AJKD.2004.03.013
U. Gerhardt, M. Riedasch, H. Hohage, Blood pressure control in kidney transplant recipients: influence of immunosuppression. Journal of Autonomic Pharmacology. ,vol. 19, pp. 49- 54 ,(1999) , 10.1046/J.1365-2680.1999.00116.X
Matthew R. Weir, Hypertension and the Kidney: Perspectives on the Relationship of Kidney Disease and Cardiovascular Disease Clinical Journal of The American Society of Nephrology. ,vol. 4, pp. 2045- 2050 ,(2009) , 10.2215/CJN.03050509
James Kiberd, Romauld Panek, Bryce Kiberd, Strategies to reduce clinical inertia in hypertensive kidney transplant recipients BMC Nephrology. ,vol. 8, pp. 10- 10 ,(2007) , 10.1186/1471-2369-8-10