Department of Immunology, Transplantology, and Internal Diseases, Medical University of Warsaw, Warsaw, Poland.
Department of Clinical Nursing, Medical University of Warsaw, Warsaw, Poland.
Ann Transplant. 2023 Oct 3;28:e939472. doi: 10.12659/AOT.939472.
BACKGROUND Hypertension is a risk factor for graft failure and mortality among kidney transplant recipients (KTRs). The aim of the study was to examine blood pressure (BP) as a factor that contributes to graft failure or death during a 10-year observation period. MATERIAL AND METHODS The study group comprised 70 KTRs who were treated according to their clinical state. Data were collected at 1 month and 1 year after transplantation and included office and ambulatory BP monitoring (ABPM) BP values, eGFR, proteinuria, and BMI. During the observation period, 6 patients died, and 10 lost the graft, but not during the first year. RESULTS Office and ABPM BP values were within normal ranges and did not differ from each other. eGRF and BMI were higher at 1 year compared to 1 month after transplantation, and proteinuria decreased. Among those who died, DBP was lower compared to those of survivors with graft failure. Proteinuria and donor age were positively correlated with BP. CONCLUSIONS Monitoring of BP and adequate treatment of hypertension resulting in BP values within normal values among KTRs contribute to longer survival of the graft and recipient. Older donor age and proteinuria could predict post-transplant hypertension. Low diastolic BP of the recipient could increase the risk of death among KTRs. Despite the fact that ABPM is the blood pressure measurement method of choice, appropriate standard office measurement could also be used for BP monitoring.
高血压是肾移植受者(KTR)移植物失败和死亡的危险因素。本研究的目的是在 10 年的观察期内,检查血压(BP)是否是导致移植物失败或死亡的因素。
研究组包括 70 名按照临床状态接受治疗的 KTR。数据收集于移植后 1 个月和 1 年,包括诊室和动态血压监测(ABPM)BP 值、eGFR、蛋白尿和 BMI。在观察期间,有 6 例死亡,10 例移植物丢失,但不是在第一年。
诊室和 ABPM 的 BP 值均在正常范围内,且彼此之间无差异。eGRF 和 BMI 在 1 年后高于移植后 1 个月,且蛋白尿减少。与存活的移植物失败患者相比,死亡患者的 DBP 较低。蛋白尿和供体年龄与 BP 呈正相关。
监测 BP 并适当治疗高血压,使 KTR 的 BP 值处于正常范围内,有助于移植物和受者的更长生存。供体年龄较大和蛋白尿可能预测移植后高血压。受者的舒张压较低可能会增加 KTR 死亡的风险。尽管 ABPM 是首选的血压测量方法,但适当的标准诊室测量也可用于 BP 监测。