Departments of Medicine, Thomas Jefferson University, Philadelphia, PA, USA.
Am J Nephrol. 2012;35(1):75-9. doi: 10.1159/000335070. Epub 2011 Dec 21.
BACKGROUND/AIMS: Living donor nephrectomy can be associated with increases in blood pressure several years following the procedure, but the best method to assess blood pressure during the living donor evaluation process is unclear.
Living kidney donors underwent casual clinic and ambulatory blood pressure monitoring (ABPM) and measurement of central aortic pressures at baseline and 6 months following donor nephrectomy.
There was a significant decline in clinic systolic blood pressure (SBP; p = 0.001) and central aortic systolic pressure (p = 0.011) during the study period. However, average ABPM was unchanged and other measures of central arterial pressures and Augmentation Index were unchanged at 6 months compared to baseline.
The remarkable differences between clinic SBP and ambulatory SBP prior to donation, and the disappearance of these differences 6 months later, suggest a substantial white coat effect on SBP associated with living kidney donor evaluation. Also, ABPM represents a better way to assess blood pressure prior to kidney donation.
背景/目的：活体供肾切除术可能会导致术后数年血压升高，但在活体供者评估过程中评估血压的最佳方法尚不清楚。
在活体供肾者中，在基线和供肾切除术后 6 个月时进行偶然诊室血压监测（ABPM）和中心主动脉压测量。
在研究期间，诊室收缩压（SBP；p = 0.001）和中心主动脉收缩压（p = 0.011）显著下降。然而，与基线相比，平均 ABPM 在 6 个月时无变化，其他中央动脉压力和增强指数也无变化。
在捐赠前诊室 SBP 和动态 SBP 之间存在显著差异，并且 6 个月后这些差异消失，这表明活体供肾评估过程中存在明显的白大衣效应。此外，ABPM 是评估捐肾前血压的更好方法。
