Relationship between renal function and blood pressure dipping status in renal transplant recipients: a longitudinal study
Abstract Background Hypertension (HT) is associated with adverse outcomes in kidney transplant (KTX) recipients. Blunting of physiological decrease in nighttime compared to daytime blood pressure (non-dipping status) is frequent in this setting. However, weather non-dipping is independently associat...
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| Format: | Article |
| Language: | English |
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BMC
2021-09-01
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| Series: | BMC Nephrology |
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| Online Access: | https://doi.org/10.1186/s12882-021-02523-7 |
| _version_ | 1818739847144144896 |
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| author | David A. Jaques Patrick Saudan Chantal Martinez Axel Andres Pierre-Yves Martin Antoinette Pechere-Bertschi Belen Ponte |
| author_facet | David A. Jaques Patrick Saudan Chantal Martinez Axel Andres Pierre-Yves Martin Antoinette Pechere-Bertschi Belen Ponte |
| author_sort | David A. Jaques |
| collection | DOAJ |
| description | Abstract Background Hypertension (HT) is associated with adverse outcomes in kidney transplant (KTX) recipients. Blunting of physiological decrease in nighttime compared to daytime blood pressure (non-dipping status) is frequent in this setting. However, weather non-dipping is independently associated with renal function decline in KTX patients is unknown. Methods We retrospectively screened KTX outpatients attending for a routine ambulatory blood pressure monitoring (ABPM) (T1) at a single tertiary hospital. Patients had two successive follow-up visits, 1 (T2) and 2 (T3) years later respectively. Routine clinical and laboratory data were collected at each visit. Mixed linear regression models were used with estimated glomerular filtration rate (eGFR) as the dependent variable. Results A total of 123 patients were included with a mean follow-up of 2.12 ± 0.45 years after ABPM. Mean age and eGFR at T1 were 56.0 ± 15.1 and 54.9 ± 20.0 mL/min/1.73m2 respectively. 61 patients (50.4%) had sustained HT and 81 (65.8%) were non-dippers. In multivariate analysis, systolic dipping status was positively associated with eGFR (p = 0.009) and compared to non-dippers, dippers had a 10.4 mL/min/1.73m2 higher eGFR. HT was negatively associated with eGFR (p = 0.003). Conclusions We confirm a high prevalence of non-dippers in KTX recipients. We suggest that preserved systolic dipping is associated with improved renal function in this setting independently of potential confounders, including HT and proteinuria. Whether modification of dipping status by chronotherapy would preserve renal function remains to be tested in clinical trials. |
| first_indexed | 2024-12-18T01:31:20Z |
| format | Article |
| id | doaj.art-0f8cd08350764ed69263d4c3af7f03f1 |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-12-18T01:31:20Z |
| publishDate | 2021-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-0f8cd08350764ed69263d4c3af7f03f12022-12-21T21:25:35ZengBMCBMC Nephrology1471-23692021-09-012211910.1186/s12882-021-02523-7Relationship between renal function and blood pressure dipping status in renal transplant recipients: a longitudinal studyDavid A. Jaques0Patrick Saudan1Chantal Martinez2Axel Andres3Pierre-Yves Martin4Antoinette Pechere-Bertschi5Belen Ponte6Division of Nephrology and Hypertension, Geneva University HospitalsDivision of Nephrology and Hypertension, Geneva University HospitalsDivision of Nephrology and Hypertension, Geneva University HospitalsDivision of Transplantation and Visceral Surgery, Geneva University HospitalsDivision of Nephrology and Hypertension, Geneva University HospitalsDivision of Nephrology and Hypertension, Geneva University HospitalsDivision of Nephrology and Hypertension, Geneva University HospitalsAbstract Background Hypertension (HT) is associated with adverse outcomes in kidney transplant (KTX) recipients. Blunting of physiological decrease in nighttime compared to daytime blood pressure (non-dipping status) is frequent in this setting. However, weather non-dipping is independently associated with renal function decline in KTX patients is unknown. Methods We retrospectively screened KTX outpatients attending for a routine ambulatory blood pressure monitoring (ABPM) (T1) at a single tertiary hospital. Patients had two successive follow-up visits, 1 (T2) and 2 (T3) years later respectively. Routine clinical and laboratory data were collected at each visit. Mixed linear regression models were used with estimated glomerular filtration rate (eGFR) as the dependent variable. Results A total of 123 patients were included with a mean follow-up of 2.12 ± 0.45 years after ABPM. Mean age and eGFR at T1 were 56.0 ± 15.1 and 54.9 ± 20.0 mL/min/1.73m2 respectively. 61 patients (50.4%) had sustained HT and 81 (65.8%) were non-dippers. In multivariate analysis, systolic dipping status was positively associated with eGFR (p = 0.009) and compared to non-dippers, dippers had a 10.4 mL/min/1.73m2 higher eGFR. HT was negatively associated with eGFR (p = 0.003). Conclusions We confirm a high prevalence of non-dippers in KTX recipients. We suggest that preserved systolic dipping is associated with improved renal function in this setting independently of potential confounders, including HT and proteinuria. Whether modification of dipping status by chronotherapy would preserve renal function remains to be tested in clinical trials.https://doi.org/10.1186/s12882-021-02523-7Ambulatory blood pressure monitoringDipping statusGlomerular filtration rateOffice blood pressureRenal transplant |
| spellingShingle | David A. Jaques Patrick Saudan Chantal Martinez Axel Andres Pierre-Yves Martin Antoinette Pechere-Bertschi Belen Ponte Relationship between renal function and blood pressure dipping status in renal transplant recipients: a longitudinal study BMC Nephrology Ambulatory blood pressure monitoring Dipping status Glomerular filtration rate Office blood pressure Renal transplant |
| title | Relationship between renal function and blood pressure dipping status in renal transplant recipients: a longitudinal study |
| title_full | Relationship between renal function and blood pressure dipping status in renal transplant recipients: a longitudinal study |
| title_fullStr | Relationship between renal function and blood pressure dipping status in renal transplant recipients: a longitudinal study |
| title_full_unstemmed | Relationship between renal function and blood pressure dipping status in renal transplant recipients: a longitudinal study |
| title_short | Relationship between renal function and blood pressure dipping status in renal transplant recipients: a longitudinal study |
| title_sort | relationship between renal function and blood pressure dipping status in renal transplant recipients a longitudinal study |
| topic | Ambulatory blood pressure monitoring Dipping status Glomerular filtration rate Office blood pressure Renal transplant |
| url | https://doi.org/10.1186/s12882-021-02523-7 |
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