Evaluation of selected risk factors of cardiovascular diseases among patients after kidney transplantation, with particular focus on the role of 24-hour automatic blood pressure measurement in the diagnosis of hypertension: an introductory report.
BACKGROUND
Arterial hypertension is a donor-related and modifiable risk factor in a graft dysfunction. The aim of the study was to perform a multi-factor analysis describing the relations between arterial hypertension and clinical parameters of a graft recipient.


METHODS
Fifty patients 3 months after a kidney transplant took part in the study. The following research tools were used: (1) 24-hour Ambulatory Blood Pressure Monitoring, ABPM; (2) traditional method - office BP; (3) the authors' questionnaire form, (4) Morisky-Green test for self-evaluation of the compliance level; (5) disease history. The relevance level was p<0.05.


RESULTS
ABPM results showed that only 8 (16%) renal transplant recipients are normotensive without any antihypertensive drugs. It was shown through ABPM that insufficient controlling of hypertension was observed in 22 patients (44%). It was shown that 9 patients (18%) had masked hypertension and 5 patients (10%) white-coat hypertension. Eight patients (16%) showed controlled daily rhythm of blood pressure ("dippers"). No statistically significant correlation between ABPM and office BP and creatinine level was observed.


CONCLUSIONS
The results of the study show insufficient control of arterial hypertension and the occurrence of masked hypertension and the white-coat effect in patients after KTx. ABPM should be routinely performed in post-KTx patients. Nonadherence to regular taking of medication and improper lifestyle of patients in the third month after KTx are not a risk factor in higher values of arterial hypertension and higher level of creatinine.
Department of Nephrological Nursing, Medical University of Warsaw, Warsaw, Poland.
Łukasz
Ł
Czyżewski
Department of Nephrological Nursing, Medical University of Warsaw, Warsaw, Poland.
Janusz
J
Wyzgał
Department of Nephrological Nursing, Medical University of Warsaw, Warsaw, Poland.
Anna
A
Kołek
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D018660:Blood Pressure Monitoring, Ambulatory; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D006977:Hypertension, Renal / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D055031:Primary Graft Dysfunction / Q000453:epidemiology*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D059466:White Coat Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D016903:Drug Monitoring
D000959:Antihypertensive Agents; D003404:Creatinine