Reverse dipper pattern of blood pressure at 3 months is associated with inflammation and outcome after renal transplantation.
Nephrol Dial Transplant
; 27(5): 2089-95, 2012 May.
Article
en En
| MEDLINE
| ID: mdl-22015441
ABSTRACT
BACKGROUND:
Cardiovascular disease is the major cause of morbidity and mortality after renal transplantation. It has been shown that both traditional and transplant-specific risk factors contribute to the high cardiovascular burden after renal transplantation The aim is to evaluate the association among ambulatory blood pressure monitoring (ABPM) at 3 months, inflammation and graft outcome.METHODS:
ABPM at 3 months was performed in 126 consecutive renal transplants. According to the nocturnal reduction of systolic blood pressure (SBP), dipper (ΔSBP ≥ 10%), non-dipper (0 < ΔSBP < 10%) and reverse dipper (SBP nocturnal rise) pattern were defined. The outcome variable was the combination of any cardiovascular event and graft failure for any reason.RESULTS:
Circadian blood pressure pattern was dipper (n = 22), non-dipper (n = 65) and reverse dipper (n = 39). Reverse dipper pattern was associated with pre-transplant diabetes (18 versus 2%, P = 0.004), body mass index (26.9 ± 5.0 versus 24.8 ± 3.8 kg/m(2), P = 0.001), calcineurin inhibitor treatment (74 versus 54%, P = 0.001) and serum soluble tumour necrosis factor receptor 2 levels (18 ± 15 versus 11 ± 6 ng/mL, P = 0.010). During 45 ± 11 months of follow-up, 22 patients reached the combined outcome variable. Multivariate Cox regression analysis showed that reverse dipper pattern [relative risk (RR) 3.50 and 95% confidence interval (CI) 1.36-8.93; P = 0.009] and creatinine clearance (RR 0.94 and 95% CI 0.91-0.98, P = 0.003) were independently associated with outcome.CONCLUSION:
The reverse dipper circadian pattern is associated with inflammation and constitutes an independent predictor of graft outcome.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Presión Sanguínea
/
Trasplante de Riñón
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Ritmo Circadiano
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Supervivencia de Injerto
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Inflamación
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Enfermedades Renales
Tipo de estudio:
Etiology_studies
/
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Aged
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Nephrol Dial Transplant
Asunto de la revista:
NEFROLOGIA
/
TRANSPLANTE
Año:
2012
Tipo del documento:
Article
País de afiliación:
España