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Abstract: PO2532

Association Between Post-Transplant Visit-to-Visit Pulse Pressure Variability and Late Transplant Systolic Blood Pressure in Non-Elderly Kidney Transplant Recipients

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Tantisattamo, Ekamol, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine School of Medicine, Orange, California, United States
  • Leelaviwat, Natnicha, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • Songtanin, Busara, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Saowapa, Sakditad, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • Vutthikraivit, Possawat, Phramongkutklao College of Medicine, Mahidol University,, Bangkok, Thailand
  • Lopimpisuth, Chawit, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Polpichai, Natchaya, Faculty of Medicine Songklanagarin Hospital, Prince of Songkla University, Songkla, Thailand
Background

Visit-to-visit blood pressure variability is associated with vascular stiffness and cardiovascular outcomes, particularly in elderly. Association between visit-to-visit pulse pressure variability (VVPPV), which takes SBP and DBP into account, and late post-kidney transplant (KT) blood pressure (BP) in different age groups is unknown.

Methods

VVPPV was examined by average successive variability ASV), which is the average absolute difference between successive BP measured at 4, 12, and 24 weeks post-KT. Since the slope of the linear plot between VVPPV and SBP at 48 week post-KT abruptly changed when VVPPV was 15 mmHg, VVPPV was then categorized into <15 and ≥15 mmHg (Figure1A). Association between the categorized VVPPV and systolic and diastolic hypertension (SHTN, DHTN) at 48 weeks defined by SBP and DBP ≥130 and ≥80 mmHg, respectively was examined by multiple logistic regression and stratified into age <60 and ≥60 years old.

Results

Of all 105 KT recipients from a single KT center, mean age±SD was 54±12 years and 64 patients (61%) was female. Mean VVPPV was 13±9 (range 2 to 50). Mean post-KT SBP and DBP at 48 weeks post-KT were 133±16 and 77±11 mmHg, respectively. In the whole study population adjusted by gender, donor type (deceased vs. living), and types of induction immunosuppressive medications, patients with VVPPV ≥15 mmHg had 3.36 times higher risk of developing SHTN (OR 3.36, P 0.02, 95%CI 1.17, 9.65). However, after additional adjustment by age and interaction term between age and ASV, the association was persist only in patients whose age <60 years old (OR<60-y/o 3.80, p 0.04, 95%CI 1.04, 13.91 vs. OR≥60-y/o 2.18, p 0.40, 95%CI 0.36, 13.31)(Figure1B). There was no association between VVPPV and DHTN in the whole study and age-stratified populations.

Conclusion

Higher VVPPV is associated with late post-KT SHTN in younger age group (< 60 years old), but not in elderly. Further studies are required to elucidate the mechanism.