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Research Article
Relationship Between Renal Function and Blood Pressure Dipping Status in Renal Transplant Recipients: A Longitudinal Study.
David Jaques
University Hospital of Geneva
Corresponding Author
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Background Hypertension (HT) is associated with adverse outcomes in renal transplant (RTX) recipients. Blunting of physiological decrease in nighttime compared to daytime blood pressure (non-dipping status) is frequent in this setting. However, weather non-dipping is independently associated with renal function decline in RTX patients is unknown.
Methods We retrospectively screened RTX outpatients attending for a routine ambulatory blood pressure monitoring (ABPM) (T1) at a single tertiary hospital. Patients had two successive follow-up visits, one (T2) and two (T3) years later respectively. Routine clinical and laboratory data were collected at each visit. Mixed linear regression models were used with estimated glomerular filtration rate (eGFR) as the dependent variable.
Results A total of 123 patients were included with a mean follow-up of 2.12 +/- 0.45 years after ABPM. Mean age and eGFR at T1 were 56.0 +/- 15.1 and 54.9 +/- 20.0 mL/min/1.73m2 respectively. 61 patients (50.4%) had sustained HT and 81 (65.8%) were non-dippers. In multivariate analysis, systolic dipping status was positively associated with eGFR (p=0.009) and compared to non-dippers, dippers had a 10.4 mL/min/1.73m2 higher eGFR. HT was negatively associated with eGFR (p=0.003).
Conclusions We confirm a high prevalence of non-dippers in RTX recipients. We show that preserved systolic dipping is associated with improved renal function in this setting independently of potential confounders, including HT and proteinuria. Whether modification of dipping status by chronotherapy would preserve renal function remains to be tested in clinical trials.
Keywords
Ambulatory blood pressure monitoring, dipping status, glomerular filtration rate, office blood pressure, renal transplant.
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CURRENT STATUS: Under Review
Version 1
Posted 04 Jan, 2021
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Editorial decision: Major revision
On 11 Jan, 2021
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On 31 Dec, 2020
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On 31 Dec, 2020
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On 31 Dec, 2020
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Subject Areas
Urology & Nephrology
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This preprint is under consideration at BMC Nephrology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Relationship Between Renal Function and Blood Pressure Dipping Status in Renal Transplant Recipients: A Longitudinal Study.
David Jaques
University Hospital of Geneva
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 04 Jan, 2021
No community comments so far
Editorial decision: Major revision
On 11 Jan, 2021
Editor assigned
On 31 Dec, 2020
Editor invited
On 31 Dec, 2020
Submission checks complete
On 31 Dec, 2020
First submitted
On 22 Dec, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Urology & Nephrology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background Hypertension (HT) is associated with adverse outcomes in renal transplant (RTX) recipients. Blunting of physiological decrease in nighttime compared to daytime blood pressure (non-dipping status) is frequent in this setting. However, weather non-dipping is independently associated with renal function decline in RTX patients is unknown.
Methods We retrospectively screened RTX outpatients attending for a routine ambulatory blood pressure monitoring (ABPM) (T1) at a single tertiary hospital. Patients had two successive follow-up visits, one (T2) and two (T3) years later respectively. Routine clinical and laboratory data were collected at each visit. Mixed linear regression models were used with estimated glomerular filtration rate (eGFR) as the dependent variable.
Results A total of 123 patients were included with a mean follow-up of 2.12 +/- 0.45 years after ABPM. Mean age and eGFR at T1 were 56.0 +/- 15.1 and 54.9 +/- 20.0 mL/min/1.73m2 respectively. 61 patients (50.4%) had sustained HT and 81 (65.8%) were non-dippers. In multivariate analysis, systolic dipping status was positively associated with eGFR (p=0.009) and compared to non-dippers, dippers had a 10.4 mL/min/1.73m2 higher eGFR. HT was negatively associated with eGFR (p=0.003).
Conclusions We confirm a high prevalence of non-dippers in RTX recipients. We show that preserved systolic dipping is associated with improved renal function in this setting independently of potential confounders, including HT and proteinuria. Whether modification of dipping status by chronotherapy would preserve renal function remains to be tested in clinical trials.
Figure 1