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
Łukasz Czyżewski, Janusz Wyzgał, Anna Kołek
Department of Nephrological Nursing, Medical University of Warsaw, Warsaw, Poland
Ann Transplant 2014; 19:188-198
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.
Material and 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.
Keywords: adherence, arterial hypertension, ABPM, Kidney Transplant