Library of the School of Health SciencesΠΜΣ Αρτηριακή Υπέρταση και Συνοδά Καρδιαγγειακά-Νεφρικά Νοσήματα
Μπολέτης Ιωάννης, Καθηγητής, Ιατρική σχολή, ΕΚΠΑ
Σαραφίδης Παντελεήμων, Αναπληρωτής Καθηγητής, Ιατρική σχολή, ΑΠΘ
Μαρινάκη Σμαράγδη, Επίκουρη Καθηγήτρια, Ιατρική σχολή, ΕΚΠΑ
24ωρη καταγραφή πίεσης και αρτηριακή σκληρία στη μεταμόσχευση νεφρού
24-hour blood pressure monitoring and arterial stiffness in kidney transplantation
Background: As interest in transplantations from living donors increases, the impact
of donation to donors is becoming more concerning. New biomarkers of cardiovascular
risk, such as arterial stiffness, may help assess the effects of donation and
cardiovascular risk on this special group.
Aim of the study: The main aim of the study is to assess the changes after donation at
a single recording of aortic pressures, amplification pressure, amplification index and
PWV as recorded using SphygmoCor device.
Material and Methods: This study is a prospective cohort study including a total of
33 kidney donors, who were examined 1 month (+/- 10 days) before scheduled kidney
donation and 3 months (+/- 10 days) after. Demographic parameters, laboratory
parameters, antihypertensive medication were recorded in these donors. Carotidfemoral pulse wave velocity (c-f PWV), blood pressure values and parameters relating
to the central waveforms were then determined. These are central aortic pressures,
amplification pressure (AP), amplification index (AIx), augmentation index adjusted
for heart rate (AIx@HR75) and the Pulse Pressure amplification (PP amplification).
Results: Study population had an average age of 54.8±11.01 years and 75.8% were
women. As expected, statistically significant difference occurred in urea, creatinine and
eGFR after donation. Blood pressure values are unaltered before donation and 3 months
later. The number of patients receiving antihypertensive therapy and the number of
antihypertensive drugs used were also unchanged. As far as central waveforms are
concerned, central aortic pressures, AP, AIx, Ax@HR75 and the PP amplification were
significantly unchanged. The median c-f PWV increased from 7(1.62) m/s to 7.55(2.23)
m/s three months after donation (p=0.011). In multiple linear regression analysis that
considered pre-donation parameters, the only factor that showed an independent
correlation with the change in c-f PWV was age (0.054 95% CI:0.001-0.107, p=0.045).
In multiple linear regression analysis that considered changes in parameters from initial
assessment prior to donation to reassessment, no factors showed independent
correlation with the change in c-f PWV.
Conclusions: This study has shown that deterioration in newer risk factors such as
arterial stiffness is not accompanied by changes in blood pressure, implying that blood
pressure measurement is not a satisfactory method of assessing long term
cardiovascular risk in living kidney donors.
Main subject category:
Living kidney donors, Arterial stiffness
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