Diurnal blood pressure changes one year after kidney transplantation : Relationship to allograft function, histology, and resistive index
Loss of circadian BP change has been linked to target organ damage and accelerated kidney function loss in hypertensive patients with and without chronic kidney disease. Ambulatory BP-derived data from 119 consecutive kidney transplant recipients who presented for the first annual evaluation were ex...
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| Veröffentlicht in: | Journal of the American Society of Nephrology 2007-05, Vol.18 (5), p.1607-1615 |
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| container_title | Journal of the American Society of Nephrology |
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| creator | WADEI, Hani M AMER, Hatem TALER, Sandra J COSIO, Fernando G GRIFFIN, Matthew D GRANDE, Joseph P LARSON, Timothy S SCHWAB, Thomas R STEGALL, Mark D TEXTOR, Stephen C |
| description | Loss of circadian BP change has been linked to target organ damage and accelerated kidney function loss in hypertensive patients with and without chronic kidney disease. Ambulatory BP-derived data from 119 consecutive kidney transplant recipients who presented for the first annual evaluation were examined in relation to allograft function, histology, and ultrasound findings. A total of 101 (85%) patients were receiving antihypertensive medications (median 2), and 85 (71%) achieved target awake average systolic BP (SBP) of |
| doi_str_mv | 10.1681/ASN.2006111289 |
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Ambulatory BP-derived data from 119 consecutive kidney transplant recipients who presented for the first annual evaluation were examined in relation to allograft function, histology, and ultrasound findings. A total of 101 (85%) patients were receiving antihypertensive medications (median 2), and 85 (71%) achieved target awake average systolic BP (SBP) of <135 mmHg. A day-night change in SBP by 10% or more (dippers) was detected in 29 (24%). Dipping status was associated with younger recipient age, lack of diabetes, low chronic vascular score, and low resistive index. Nondippers and reverse dippers had lower GFR compared with dippers (P = 0.04). For every 10% nocturnal drop in SBP, GFR increased by 4.6 ml/min per 1.73 m(2) (R = 0.3, P = 0.003). Nondippers and reverse dippers were equally common in recipients with normal histology and in those with pathologic findings on surveillance biopsy. On multivariate analysis, percentage of nocturnal fall in SBP and elevated resistive index independently correlated with GFR. This study indicates that lack of nocturnal fall in SBP is related to poor allograft function, high chronic vascular score, and high resistive index irrespective of allograft fibrosis. Further studies are needed to determine whether restoration of normal BP pattern will confer better allograft outcome.</description><identifier>ISSN: 1046-6673</identifier><identifier>EISSN: 1533-3450</identifier><identifier>DOI: 10.1681/ASN.2006111289</identifier><identifier>PMID: 17409307</identifier><identifier>CODEN: JASNEU</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adolescent ; Adult ; Aged ; Biological and medical sciences ; Blood Pressure - physiology ; Circadian Rhythm ; Female ; Follow-Up Studies ; Glomerular Filtration Rate - physiology ; Humans ; Hypertension - physiopathology ; Kidney - anatomy & histology ; Kidney - diagnostic imaging ; Kidney Transplantation - physiology ; Male ; Medical sciences ; Middle Aged ; Nephrology. Urinary tract diseases ; Tissue Donors ; Transplantation, Homologous - physiology ; Ultrasonography</subject><ispartof>Journal of the American Society of Nephrology, 2007-05, Vol.18 (5), p.1607-1615</ispartof><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18737481$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17409307$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>WADEI, Hani M</creatorcontrib><creatorcontrib>AMER, Hatem</creatorcontrib><creatorcontrib>TALER, Sandra J</creatorcontrib><creatorcontrib>COSIO, Fernando G</creatorcontrib><creatorcontrib>GRIFFIN, Matthew D</creatorcontrib><creatorcontrib>GRANDE, Joseph P</creatorcontrib><creatorcontrib>LARSON, Timothy S</creatorcontrib><creatorcontrib>SCHWAB, Thomas R</creatorcontrib><creatorcontrib>STEGALL, Mark D</creatorcontrib><creatorcontrib>TEXTOR, Stephen C</creatorcontrib><title>Diurnal blood pressure changes one year after kidney transplantation : Relationship to allograft function, histology, and resistive index</title><title>Journal of the American Society of Nephrology</title><addtitle>J Am Soc Nephrol</addtitle><description>Loss of circadian BP change has been linked to target organ damage and accelerated kidney function loss in hypertensive patients with and without chronic kidney disease. Ambulatory BP-derived data from 119 consecutive kidney transplant recipients who presented for the first annual evaluation were examined in relation to allograft function, histology, and ultrasound findings. A total of 101 (85%) patients were receiving antihypertensive medications (median 2), and 85 (71%) achieved target awake average systolic BP (SBP) of <135 mmHg. A day-night change in SBP by 10% or more (dippers) was detected in 29 (24%). Dipping status was associated with younger recipient age, lack of diabetes, low chronic vascular score, and low resistive index. Nondippers and reverse dippers had lower GFR compared with dippers (P = 0.04). For every 10% nocturnal drop in SBP, GFR increased by 4.6 ml/min per 1.73 m(2) (R = 0.3, P = 0.003). Nondippers and reverse dippers were equally common in recipients with normal histology and in those with pathologic findings on surveillance biopsy. On multivariate analysis, percentage of nocturnal fall in SBP and elevated resistive index independently correlated with GFR. This study indicates that lack of nocturnal fall in SBP is related to poor allograft function, high chronic vascular score, and high resistive index irrespective of allograft fibrosis. Further studies are needed to determine whether restoration of normal BP pattern will confer better allograft outcome.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Blood Pressure - physiology</subject><subject>Circadian Rhythm</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glomerular Filtration Rate - physiology</subject><subject>Humans</subject><subject>Hypertension - physiopathology</subject><subject>Kidney - anatomy & histology</subject><subject>Kidney - diagnostic imaging</subject><subject>Kidney Transplantation - physiology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Tissue Donors</subject><subject>Transplantation, Homologous - physiology</subject><subject>Ultrasonography</subject><issn>1046-6673</issn><issn>1533-3450</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkEtvFDEMgCMEoqVw5YhygVNnyTsz3KpSHlIFEo_zyJNHN5BNpskM6v4E_jUpXWlPtuzPtvwh9JKSDVU9fXvx_cuGEaIopawfHqFTKjnvuJDkccuJUJ1Smp-gZ7X-IoRKpvVTdEK1IAMn-hT9fR_WkiDiKeZs8VxcrWtx2Gwh3biKc3J476Bg8Isr-Hewye3xUiDVOUJaYAk54Xf4m4v_07oNM14yhhjzTWlD2K_J3HfO8TbUJbfy_hxDsridaoXwx-GQrLt7jp54iNW9OMQz9PPD1Y_LT93114-fLy-uO8N0v3RgJmYJ8B7k5IT3UgjQYJXqJ22MZNKxCbjVg-W2HzwXHkBJyRiXcvBE8DP05mHvXPLt6uoy7kI1LrZvXF7rqIlgnCvawM0DaEqutTg_ziXsoOxHSsZ7-WOTPx7lt4FXh83rtHP2iB9sN-D1AYBqIPpm0YR65HrNtegp_wcLKI-s</recordid><startdate>20070501</startdate><enddate>20070501</enddate><creator>WADEI, Hani M</creator><creator>AMER, Hatem</creator><creator>TALER, Sandra J</creator><creator>COSIO, Fernando G</creator><creator>GRIFFIN, Matthew D</creator><creator>GRANDE, Joseph P</creator><creator>LARSON, Timothy S</creator><creator>SCHWAB, Thomas R</creator><creator>STEGALL, Mark D</creator><creator>TEXTOR, Stephen C</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20070501</creationdate><title>Diurnal blood pressure changes one year after kidney transplantation : Relationship to allograft function, histology, and resistive index</title><author>WADEI, Hani M ; AMER, Hatem ; TALER, Sandra J ; COSIO, Fernando G ; GRIFFIN, Matthew D ; GRANDE, Joseph P ; LARSON, Timothy S ; SCHWAB, Thomas R ; STEGALL, Mark D ; TEXTOR, Stephen C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c278t-acb2d0a38a5be4ff544a7ad668b7cc525e2ba3d79d3d89f34faa655223559f043</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Blood Pressure - physiology</topic><topic>Circadian Rhythm</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Glomerular Filtration Rate - physiology</topic><topic>Humans</topic><topic>Hypertension - physiopathology</topic><topic>Kidney - anatomy & histology</topic><topic>Kidney - diagnostic imaging</topic><topic>Kidney Transplantation - physiology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Tissue Donors</topic><topic>Transplantation, Homologous - physiology</topic><topic>Ultrasonography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>WADEI, Hani M</creatorcontrib><creatorcontrib>AMER, Hatem</creatorcontrib><creatorcontrib>TALER, Sandra J</creatorcontrib><creatorcontrib>COSIO, Fernando G</creatorcontrib><creatorcontrib>GRIFFIN, Matthew D</creatorcontrib><creatorcontrib>GRANDE, Joseph P</creatorcontrib><creatorcontrib>LARSON, Timothy S</creatorcontrib><creatorcontrib>SCHWAB, Thomas R</creatorcontrib><creatorcontrib>STEGALL, Mark D</creatorcontrib><creatorcontrib>TEXTOR, Stephen C</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American Society of Nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>WADEI, Hani M</au><au>AMER, Hatem</au><au>TALER, Sandra J</au><au>COSIO, Fernando G</au><au>GRIFFIN, Matthew D</au><au>GRANDE, Joseph P</au><au>LARSON, Timothy S</au><au>SCHWAB, Thomas R</au><au>STEGALL, Mark D</au><au>TEXTOR, Stephen C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diurnal blood pressure changes one year after kidney transplantation : Relationship to allograft function, histology, and resistive index</atitle><jtitle>Journal of the American Society of Nephrology</jtitle><addtitle>J Am Soc Nephrol</addtitle><date>2007-05-01</date><risdate>2007</risdate><volume>18</volume><issue>5</issue><spage>1607</spage><epage>1615</epage><pages>1607-1615</pages><issn>1046-6673</issn><eissn>1533-3450</eissn><coden>JASNEU</coden><abstract>Loss of circadian BP change has been linked to target organ damage and accelerated kidney function loss in hypertensive patients with and without chronic kidney disease. Ambulatory BP-derived data from 119 consecutive kidney transplant recipients who presented for the first annual evaluation were examined in relation to allograft function, histology, and ultrasound findings. A total of 101 (85%) patients were receiving antihypertensive medications (median 2), and 85 (71%) achieved target awake average systolic BP (SBP) of <135 mmHg. A day-night change in SBP by 10% or more (dippers) was detected in 29 (24%). Dipping status was associated with younger recipient age, lack of diabetes, low chronic vascular score, and low resistive index. Nondippers and reverse dippers had lower GFR compared with dippers (P = 0.04). For every 10% nocturnal drop in SBP, GFR increased by 4.6 ml/min per 1.73 m(2) (R = 0.3, P = 0.003). Nondippers and reverse dippers were equally common in recipients with normal histology and in those with pathologic findings on surveillance biopsy. On multivariate analysis, percentage of nocturnal fall in SBP and elevated resistive index independently correlated with GFR. This study indicates that lack of nocturnal fall in SBP is related to poor allograft function, high chronic vascular score, and high resistive index irrespective of allograft fibrosis. Further studies are needed to determine whether restoration of normal BP pattern will confer better allograft outcome.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>17409307</pmid><doi>10.1681/ASN.2006111289</doi><tpages>9</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Biological and medical sciences Blood Pressure - physiology Circadian Rhythm Female Follow-Up Studies Glomerular Filtration Rate - physiology Humans Hypertension - physiopathology Kidney - anatomy & histology Kidney - diagnostic imaging Kidney Transplantation - physiology Male Medical sciences Middle Aged Nephrology. Urinary tract diseases Tissue Donors Transplantation, Homologous - physiology Ultrasonography |
| title | Diurnal blood pressure changes one year after kidney transplantation : Relationship to allograft function, histology, and resistive index |
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