title: Assessment of long-term cardiovascular effects of unilateral nephrectomy.
abstract: OBJECTIVE
  There is conflicting evidence regarding long-term effects of unilateral nephrectomy such as cardiovascular diseases. Excessive increase in blood pressure (BP) during exercise called "hypertensive response to exercise" may be a sign of unborn hypertension and increased cardiovascular risk. Decrease in glomerular filtration rate (GFR) in patients with unilateral nephrectomy may be associated with disturbance of circadian BP changes without affecting the absolute levels of BP. We aimed to investigate the circadian BP changes and hypertensive response to exercise in normotensive patients with preserved renal functions who had undergone unilateral nephrectomy for other causes rather than organ donation.
  
  
  METHODS
  This study enrolled 32 patients (mean age 43.4 ± 9.9 years, male 15) with unilateral nephrectomy and 40 healthy controls (mean age 47 ± 6.1 years, male 17). All patients were undergone both office and ambulatory BP measurements and treadmill stress test.
  
  
  RESULTS
  The median time since nephrectomy was 12 (9-22) years in the patient group. The median GFR of the patient group was lower than that of the controls without significance [85.1 (76.0-97.9) vs. 93.2 (84.5-104.9), respectively; p = 0.14]. There was no significant difference between groups in terms of office BP measurements, night time diastolic and systolic BP, mean arterial pressure (MAP), night/day time ratio of MAP in ambulatory BP measurements. The results of treadmill stress tests and hypertensive response to exercise ratios were also similar between the groups.
  
  
  CONCLUSIONS
  This study revealed that there was no increase in long-term cardiovascular risks one decade after unilateral nephrectomy based on circadian BP changes and hypertensive response to exercise in normotensive patients.
authors.affiliation: Department of Nephrology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey. dr.s.guvenir@hotmail.com.
authors.forename: Sultan
authors.initials: S
authors.lastname: Ozkurt
authors.affiliation: Department of Cardiology, Faculty of Medicine, Çorum Hitit University, Çorum, Turkey.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Karavelioglu
authors.affiliation: Department of Cardiology, Hitit University Çorum Training and Research Hospital, Çorum, Turkey.
authors.forename: Macit
authors.initials: M
authors.lastname: Kalcik
authors.affiliation: Department of Biostatistics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Musmul
mesh_terms: D000328:Adult; D000367:Age Factors; D001795:Blood Pressure Determination; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D016022:Case-Control Studies; D005080:Exercise Test / Q000379:methods*; D017079:Exercise Tolerance / Q000502:physiology; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects* / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D013995:Time
keywords: Blood pressure; Cardiovascular risk; Chronic kidney disease; Treadmill stress test; Unilateral nephrectomy