Your browser doesn't support javascript.
loading
The impact of blood pressure variability and pulse pressure on graft survival and mortality after kidney transplantation.
Pagonas, Nikolaos; Markakis, Konstantinos; Bauer, Frederic; Seibert, Felix S; Seidel, Max; Zidek, Walter; Kykalos, Stylianos; Sasko, Benjamin; Klein, Thomas; Babel, Nina; Viebahn, Richard; Westhoff, Timm H.
Afiliação
  • Pagonas N; Universitätsklinikum Marien Hospital Herne, Medizinische Klinik I, Ruhr-University of Bochum, Bochum, Germany.
  • Markakis K; Department of Cardiology and Angiology, Medical University Brandenburg, Brandenburg, Germany.
  • Bauer F; Universitätsklinikum Marien Hospital Herne, Medizinische Klinik I, Ruhr-University of Bochum, Bochum, Germany.
  • Seibert FS; Universitätsklinikum Marien Hospital Herne, Medizinische Klinik I, Ruhr-University of Bochum, Bochum, Germany.
  • Seidel M; Universitätsklinikum Marien Hospital Herne, Medizinische Klinik I, Ruhr-University of Bochum, Bochum, Germany.
  • Zidek W; Universitätsklinikum Marien Hospital Herne, Medizinische Klinik I, Ruhr-University of Bochum, Bochum, Germany.
  • Kykalos S; Department of Nephrology, Charité - Campus Benjamin Franklin, Berlin, Germany.
  • Sasko B; Department of General, Visceral and Transplant Surgery, University Hospital Knappschaftskrankenhaus Bochum, Ruhr-University Bochum, Bochum, Germany.
  • Klein T; Universitätsklinikum Marien Hospital Herne, Medizinische Klinik I, Ruhr-University of Bochum, Bochum, Germany.
  • Babel N; Department of Cardiology and Angiology, Medical University Brandenburg, Brandenburg, Germany.
  • Viebahn R; Universitätsklinikum Marien Hospital Herne, Medizinische Klinik I, Ruhr-University of Bochum, Bochum, Germany.
  • Westhoff TH; Universitätsklinikum Marien Hospital Herne, Medizinische Klinik I, Ruhr-University of Bochum, Bochum, Germany.
Clin Transplant ; 33(1): e13448, 2019 01.
Article em En | MEDLINE | ID: mdl-30427068
BACKGROUND: Blood pressure variability and pulse pressure are strong and independent predictors of cardiovascular morbidity and mortality in the general population. So far, there are no data on the impact of blood pressure variability on mortality and graft survival after renal transplantation. METHODS: We performed a retrospective analysis of 877 patients who underwent kidney transplantation between 1997 and 2011 in two transplant centers in Germany (Berlin and Bochum) with a follow-up of 12-266 months. Visit-to-visit blood pressure variability over the first 12 months after transplantation (3 visits) and during the first 120 months after transplantation (7 visits) was calculated as the coefficient of variation (CV = standard deviation (SD)/mean blood pressure). Patient and graft survival was defined as composite endpoint. RESULTS: Cumulative survival was significantly higher for those patients with lower systolic blood pressure and pulse pressure within both the first 12 months and the 120 months posttransplant. After adjustment of data for gender, age, body mass index, and coronary artery disease, the cumulative incidence of the combined endpoint did not significantly differ between patients with lower vs higher CV (12 months CV hazard ratio (HR) (95% CI) = 0.90 (0.66-1.23), P = 0.51; 120 months CV HR (95% CI) = 0.92 (0.67-1.26), P = 0.60). A lower systolic blood pressure remained highly predictive for better survival in adjusted analyses. CONCLUSION: Visit-to-visit blood pressure variability is not associated with mortality or graft loss after kidney transplantation in this retrospective analysis. In analogy to the general population, however, there is an inverse relationship of survival and pulse pressure as a marker of arterial stiffness.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Pressão Sanguínea / Doenças Cardiovasculares / Transplante de Rim / Rejeição de Enxerto / Sobrevivência de Enxerto / Hipertensão / Falência Renal Crônica Idioma: En Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Alemanha

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Pressão Sanguínea / Doenças Cardiovasculares / Transplante de Rim / Rejeição de Enxerto / Sobrevivência de Enxerto / Hipertensão / Falência Renal Crônica Idioma: En Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Alemanha