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1、CLINICALANDTRANSLATIONALRESEARCHHypertensioninChronicKidneyDisease:TheInfluenceofRenalTransplantation11111MariaA.Azancot,NataliaRamos,FrancescJ.Moreso,MeritxellIbernon,EugeniaEspinel,111,2IrinaB.Torres,JoanFort,andDanielSeronBackground.Hypertensionisoneofthemost
2、prevalentcardiovascularriskfactorsinchronickidneydisease(CKD)andkidneytransplants.ThecontributionoftransplantationtohypertensionincomparisontopatientswithCKDandsimilarrenalfunctionhasnotbeencharacterized.Methods.Ninety-twotransplantsand97CKDpatientswithanestimat
3、edglomerularfiltrationratelessthan60mL/min/21.73mnotreceivingdialysiswereenrolled.Atentry,officebloodpressure(BP)and24-hrambulatorybloodpressuremonitoring(ABPM)wereobtained.Results.OfficeBPwasnotdifferentbetweentransplantsandCKDpatients(139.5T14.3vs.135.2T19.3,P
4、=1.00,re-spectively).ABPM24-hrsystolicbloodpressure(SBP)(133.9T14.3vs.126.2T16.1,P=0.014),awakeSBP(135.6T15.2vs.128.7T16.2,P=0.042),andsleepSBP(131.2T16.2vs.120.2T17.9,P=0.0014)werehigherinrenaltransplants.WhenpatientswereclassifiedaccordingtoBPpatternsassociate
5、dwithhighestcardiovascularrisk,theproportionofpatientswithbothnocturnalhypertensionandnon-dipperpatternwashigherintransplants(68.5%vs.47.4%,P=0.03).Inthemultivariateregressionanalysis,transplantationwasanindependentpredictorof24-hr,awake,andsleepSBP.Conclusion.O
6、fficeBPissimilarinkidneytransplantsandCKDpatientswithsimilarrenalfunction.Onthecontrary,hypertensionismoresevereinkidneytransplantswhenevaluatedwithABPMmainlyasaresultofincreasedsleepsystolicBP.Thus,preciseevaluationofhypertensioninkidneytransplantsrequiresABPM.
7、Keywords:Kidneytransplantation,Chronickidneydisease,Hypertension,Ambulatorybloodpressuremonitoring.(Transplantation2014;98:537Y542)Hypertensionisanimportantriskfactorforcardiovas-stage1and96%instages4and5(3).Transplantationistheculareventsandprogressionofchronic
8、kidneydiseasebesttreatmentforend-stagerenalfailure(4),allowingpar-(CKD)(1,2).Itsprevalenceis79%inpatientswithCKDtialrecoveryofrenalfunction.However,approximately70%of
