Systolic Blood Pressure Diurnal Variation is Not a Predictor of Renal Target Organ Damage in Kidney Transplant Recipients

Abstract

Elevated blood pressure and diurnal blood pressure variation detected by ambulatory blood pressure monitoring has been shown to be predictive of worse outcome in end-stage renal disease patients in small studies. What has been lacking is a large study to determine whether these ambulatory blood pressure monitoring (ABPM)-derived variables are predictors of worse outcome in renal transplant recipients. All the patients that underwent renal transplantation and follow up at this institution from January 1998 till October 2002 were involved in this study (n = 177). All patients were followed up for at least 48 weeks. Last creatinine correlated positively with duration of dialysis (p = 0.035, r = 0.158), kidney-donor age (p < 0.0001, r = 0.377), early kidney function (p < 0.0001, r = 0.610, r = 0.683), 24-h systolic blood pressure (SBP) load (p = 0.002, r = 0.228), and ABPM-derived pulse pressure (p < 0.0001, r = 0.269). However neither office blood pressure nor SBP diurnal variation were predictors of kidney outcome. Regression analysis showed that early kidney function was the only independent predictor of transplant outcome (p < 0.0001). Systolic blood pressure diurnal variation, though an important predictor of target organ damage in chronic kidney disease patients, was not a predictor of renal transplant function in renal transplant recipients. Only early kidney function was an independent predictor of later serum creatinine.