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Scientific article
Open access
English

Relationship between renal function and blood pressure dipping status in renal transplant recipients: a longitudinal study

Published inBMC nephrology, vol. 22, no. 1, 325
Publication date2021-09-30
First online date2021-09-30
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.

eng
Keywords
  • Ambulatory blood pressure monitoring
  • Dipping status
  • Glomerular filtration rate
  • Office blood pressure
  • Renal transplant
Funding
  • Geneva University Hospitals - [PRD 10-2016-II]
Citation (ISO format)
JAQUES, David et al. Relationship between renal function and blood pressure dipping status in renal transplant recipients: a longitudinal study. In: BMC nephrology, 2021, vol. 22, n° 1, p. 325. doi: 10.1186/s12882-021-02523-7
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Article (Published version)
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Identifiers
ISSN of the journal1471-2369
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Technical informations

Creation10/07/2021 2:04:00 PM
First validation10/07/2021 2:04:00 PM
Update time03/16/2023 2:18:54 AM
Status update03/16/2023 2:18:53 AM
Last indexation01/29/2024 11:15:10 PM
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