Ambulatory blood pressure trajectories and blood pressure variability in kidney transplant recipients: a comparative study against chronic kidney disease patients

Korogiannou, Maria; Theodorakopoulou, Marieta; Sarafidis, Pantelis A.; Alexandrou, Maria Eleni; Pella, Eva; Xagas, Efstathios; Argyris, Antonis; Protogerou, Athanase D.; Papagianni, Αikaterini; Boletis, Ioannis; Marinaki, Smaragdi

doi:10.23876/j.krcp.21.250

Cited by 5 publications

(4 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, a recent case-control study with 306 participants ( n = 204 KTRs and 102 hemodialysis patients) showed that short-term BPV levels are significantly lower in KTRs than in age and sex-matched hemodialysis patients [28]. Finally, in a recent work from our group comparing short-term BPV between KTRs and predialysis CKD individuals (matched for age, sex and estimated glomerular filtration rate), we found no significant differences between the two groups in all BPV indices studied except for DBP-SD [29].…”

Section: Discussionmentioning

confidence: 84%

Sex-related short-term blood pressure variability differences in kidney transplant recipients

Korogiannou

Alexandrou²,

Sarafidis³

et al. 2022

Blood Pressure Monitoring

Self Cite

View full text Add to dashboard Cite

Objective Kidney transplant recipients (KTRs) display higher cardiovascular morbidity and mortality than the general population. Increased short-term blood pressure variability (BPV) is associated with a higher risk of adverse cardiovascular outcomes in chronic kidney disease (CKD). The aim of this study is to investigate sex differences in short-term BPV in KTRs. Methods In total, 136 male and 69 female KTRs with valid 24 h ambulatory blood pressure monitoring were included in this analysis. Systolic and diastolic BPV indices [SD, weighted SD (wSD), coefficient of variation (CV), average real variability (ARV) and variability independent of the mean (VIM)] were calculated with validated formulas for the 24 h, daytime and nighttime periods. Results Age, time from transplantation surgery and history of major comorbidities did not differ between men and women. During the 24-h period, systolic BPV indices did not differ between men and women (SBP-ARV: 9.4 ± 2.2 vs. 9.9 ± 2.5; P = 0.212). During the daytime period, SBP-CV and SBP-VIM were significantly higher in females compared with male participants (SBP-CV: 9.9 ± 2.4 vs. 11 ± 3.1%; P = 0.022 and SBP-VIM: 12.6 ± 3.0 vs 14.2 ± 3.9; P = 0.008); daytime SBP-SD and SBP-ARV, and all studied indexes during nighttime did not differ between groups. No significant between-group differences in 24 h and daytime diastolic BPV indices were detected. Nighttime DBP-CV was marginally higher in men (12.0 ± 3.6 vs. 11.4 ± 4.0; P = 0.053); the rest nighttime diastolic BPV indices measured were also nonsignificantly higher in men. Conclusion In conclusion, 24-h systolic and diastolic BPV parameters did not differ between male and female KTRs, but short-term BPV over the respective day- and nighttime periods showed different trends in men and women. Further studies are needed to examine possible differences in long-term BPV in KTRs.

show abstract

Section: Discussionmentioning

confidence: 84%

Sex-related short-term blood pressure variability differences in kidney transplant recipients

Korogiannou

Alexandrou²,

Sarafidis³

et al. 2022

Blood Pressure Monitoring

Self Cite

View full text Add to dashboard Cite

show abstract

“…In a comparative study of KTR and CKD patients (matched for age, sex, and estimated glomerular filtration rate, n = 93 per group) BP levels, BP trajectories, and short-term BP variability indices were not different between KTR and CKD patients except for a slightly higher nighttime diastolic blood pressure (DBP) and slightly lower DBP standard deviation in KTR [20 ▪ ]. In addition, short-term BP variability did not change significantly at 3 and 12 months posttransplant compared to the baseline BP variability 1-month pretransplant [21 ▪ ].…”

Section: Blood Pressure Measurement Modalities In Kidney Transplant R...mentioning

confidence: 95%

A paradigm shift from office to home-based blood pressure measurement approaches in kidney transplant recipients

Tantisattamo,

Ferrey,

Reddy

et al. 2023

Current Opinion in Nephrology &Amp; Hypertension

View full text Add to dashboard Cite

Purpose of review The unattended blood pressure (BP) readings from home blood pressure (HBP) monitoring should provide more accurate BP readings than attended BP obtained from office blood pressure (OBP). Here, we review evidence supporting the clinical utility of HBP and automatic remote monitoring of blood pressure (ARM-BP) in kidney transplant recipients (KTR). Recent findings BP from 24-h ambulatory blood pressure monitoring (24-h ABPM) is higher than but better associated with kidney and cardiovascular outcomes compared to OBP and HBP. While there is discordance of BP readings across different BP measurement methods causing BP misclassification, HBP provides BP readings closer to the readings from the 24-h ABPM than those from OBP. Systolic and diastolic BP is better controlled within 30 days after utilizing ARM-BP. Summary Compared to OBP, HBP minimizes the attended effect of OBP, and its readings are closer to the gold standard 24-h ABPM. ARM-BP improves BP control in the short term and trials of longer follow-up duration are required to evaluate sustained clinical benefits in KTR. The paradigm of BP monitoring may shift toward HBP, while OBP may be utilized primarily for KTR who cannot perform HBP for hypertension diagnosis and management.

show abstract

“…The 2023 ESH Guidelines also discuss in considerable length the management of hypertension in kidney transplant recipients (KTRs) [ 1 ]. The guidelines discuss that kidney transplantation per se is associated with significant improvements in BP (8/5 mmHg in ambulatory BP) in the short- and mid-term post-transplant periods along with reduction in antihypertensive agents [ 103 , 104 ]; as such, ambulatory BP in KTRs is significantly lower than that in carefully matched hemodialysis patients and similar to patients with CKD with matched kidney function [ 105 , 106 ]. Despite these improvements, hypertension represents the most prevalent comorbidity post transplantation, with ABPM studies estimating hypertension prevalence in >95% of KTRs [ 107 ].…”

Section: Hypertension In Kidney Transplant Recipientsmentioning

confidence: 99%

A European Renal Association (ERA) synopsis for nephrology practice of the 2023 European Society of Hypertension (ESH) Guidelines for the Management of Arterial Hypertension

Sarafidis,

Schmieder,

Burnier

et al. 2024

Nephrology Dialysis Transplantation

Self Cite

View full text Add to dashboard Cite

In June 2023, the European Society of Hypertension (ESH) presented and published the new 2023 ESH Guidelines for the Management of Arterial Hypertension, a document that was endorsed by the European Renal Association (ERA). Following the evolution of evidence in recent years, several novel recommendations relevant to the management of hypertension in patients with chronic kidney disease (CKD) appeared in these Guidelines. These include recommendations for target office BP < 130/80 mmHg in most and against target office BP < 120/70 mmHg in all patients with CKD; recommendations for use of spironolactone or chlortalidone for patients with resistant hypertension with eGFR higher or lower than 30 ml/min/1.73 m2, respectively; use of an SGLT2-inhibitor for patients with CKD and eGFR ≥20 ml/min/1.73 m2; use of finerenone for patients with CKD, type 2 DM, albuminuria, eGFR ≥25 ml/min/1.73 m2 and serum potassium < 5.0 mmol/L; and revascularization in patients with atherosclerotic renovascular disease and secondary hypertension or high-risk phenotypes if stenosis ≥ 70% is present. The present report is a synopsis of sections of the ESH Guidelines that are relevant to the daily clinical practice of nephrologists, prepared by experts of ESH and ERA. The sections summarized are those referring to the role of CKD in hypertension staging and cardiovascular risk stratification, the evaluation of hypertension-mediated kidney damage and the overall management of hypertension in patients with CKD.

show abstract

Ambulatory blood pressure trajectories and blood pressure variability in kidney transplant recipients: a comparative study against chronic kidney disease patients

Cited by 5 publications

References 34 publications

Sex-related short-term blood pressure variability differences in kidney transplant recipients

Sex-related short-term blood pressure variability differences in kidney transplant recipients

A paradigm shift from office to home-based blood pressure measurement approaches in kidney transplant recipients

A European Renal Association (ERA) synopsis for nephrology practice of the 2023 European Society of Hypertension (ESH) Guidelines for the Management of Arterial Hypertension

Contact Info

Product

Resources

About