A comparison between office and ambulatory blood pressure measurements in renal transplant patients with chronic transplant nephropathy

Kooman, Jeroen P.; Christiaans, M. H. L.; Boots, Johannes M. M.; Sande, Frank M. van der; Leunissen, Karel M.L.; Hooff, J. P. van

doi:10.1053/ajkd.2001.24518

Cited by 46 publications

(41 citation statements)

References 19 publications

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“…They could only be included if they had a 20% rise or more in serum creatinine, or a doubling of the urinary albumin excretion during the previous year. Both proteinuria and an increase in serum creatinine level have been taken as clinical signs of chronic transplant nephropathy [14]. The majority of our patients were not biopsied.…”

Section: Discussionmentioning

confidence: 99%

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Office blood pressure measurements overestimate blood pressure control in renal transplant patients

Stenehjem

Gudmundsdottir

Os³

2006

Blood Pressure Monitoring

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Section: Discussionmentioning

confidence: 99%

“…These inclusion criteria have been used by others as both albuminuria and elevations of serum creatinine are clinical signs of chronic transplant nephropathy [14]. Renal biopsy was not routinely performed.…”

Section: Methodsmentioning

confidence: 99%

Office blood pressure measurements overestimate blood pressure control in renal transplant patients

Stenehjem

Gudmundsdottir

Os³

2006

Blood Pressure Monitoring

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“…In those studies a significant positive relationship between the loss of renal function, as indicated by an increase of serum creatinine or decline of glomerular filtration rate (GFR), and systolic BP was observed [29,30]. These two studies were performed in adults and ABPM and CBP showed no difference in baseline BP values, but were significantly different 5 years after transplantation.…”

Section: Bp and Allograft Functionmentioning

confidence: 99%

Pathomechanisms and the diagnosis of arterial hypertension in pediatric renal allograft recipients

Vester¹,

Wingen²,

Hoyer³

2004

Pediatr Nephrol

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Arterial hypertension is common in pediatric renal allograft recipients. While the causes are multifactorial, including chronic graft rejection, immunosuppressive therapy, and renal vascular disorders, the effect of hypertension on renal allograft function is detrimental. As in adults, if not treated early and aggressively, hypertension may lead to cardiovascular damage and graft failure. Pathophysiological changes in the arteries and kidney af-ter renal transplantation and the impact of receptor regulation have not been studied extensively in children. For identifying children with hypertension following renal transplantation casual blood pressure measurements do not accurately reflect average arterial blood pressure and circadian blood pressure rhythm. Ambulatory 24-h blood pressure monitoring should regularly be applied in trans-plant patients. The purpose of this review is to analyze pathophysiological aspects of risk factors for arterial hypertension and underline the importance of regular blood pressure monitoring and early therapeutic intervention.

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“…58,59 When possible, ambulatory BP monitoring is recommended because a circadian 'non-dipping' pattern is often seen in KTRs. [60][61][62] Such patients might require higher doses of anti-hypertensive medications in the evenings. 63 The management of hypertension should include simultaneous initiation of lifestyle modification and drug therapy.…”

Section: Cigarette Smokingmentioning

confidence: 99%

Primary Care of the Renal Transplant Patient

et al. 2010

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There has been a remarkable rise in the number of kidney transplant recipients (KTR) in the US over the last decade. Increasing use of potent immunosuppressants, which are also potentially diabetogenic and atherogenic, can result in worsening of pre-existing medical conditions as well as development of post-transplant disease. This, coupled with improving long-term survival, is putting tremendous pressure on transplant centers that were not designed to deliver primary care to KTR. Thus, increasing numbers of KTR will present to their primary care physicians (PCP) post-transplant for routine medical care. Similar to native chronic kidney disease patients, KTRs are vulnerable to cardiovascular disease as well as a host of other problems including bone disease, infections and malignancies. Deaths related to complications of cardiovascular disease and malignancies account for 60-65% of long-term mortality among KTRs. Guidelines from the National Kidney Foundation and the European Best Practice Guidelines Expert Group on the management of hypertension, dyslipidemia, smoking, diabetes and bone disease should be incorporated into the long-term care plan of the KTR to improve outcomes. A number of transplant centers do not supply PCPs with protocols and guidelines, making the task of the PCP more difficult. Despite this, PCPs are expected to continue to provide general preventive medicine, vaccinations and management of chronic medical problems. In this narrative review, we examine the common medical problems seen in KTR from the PCP's perspective. Medical management issues related to immunosuppressive medications are also briefly discussed.

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A comparison between office and ambulatory blood pressure measurements in renal transplant patients with chronic transplant nephropathy

Cited by 46 publications

References 19 publications

Office blood pressure measurements overestimate blood pressure control in renal transplant patients

Office blood pressure measurements overestimate blood pressure control in renal transplant patients

Pathomechanisms and the diagnosis of arterial hypertension in pediatric renal allograft recipients

Primary Care of the Renal Transplant Patient

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