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Abstract: PO2161

Early Post Renal Transplant Hypertension: Incidence of Masked Hypertension and Hemodynamic Correlates

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Paramasivam, Vijayakumar, Baystate Medical Center, Springfield, Massachusetts, United States
  • Greco, Barbara A., Baystate Medical Center, Springfield, Massachusetts, United States
  • Hodgins, Spencer, Baystate Medical Center, Springfield, Massachusetts, United States
Background

Hypertension following renal transplantation is prevalent and impacts long term graft survival. Masked and white coat hypertension have been reported in patients with renal allografts. The onset and mechanism of masked hypertension in these patients is poorly understood. We report preliminary data from an ongoing prospective observational study of HTN in the early post-transplant period.

Methods

40 patients with ESRD who undertook renal transplantation at Baystate Medical Center from June of 2019 to April of 2021 consented to participate in a prospective observational study assessing office BP and ambulatory blood pressure monitoring (ABPM). ABPM was performed at 1 month and at 3-4 months post-transplant. At the same time periods, bioimpedance measures including cardiac index (CI), total peripheral resistance (TPR) and total body water (TBW), were obtained using a whole body bioimpedance technology (NiCAStm). Patient demographics, office blood pressures (BP), ABPM and bioimpedance data were analyzed to determine rate of masked and white coat hypertension (HTN).

Results

33 of 40 patients completed ABPM at 1 month and 16 completed the 3-4 month ABPM. Mean office BP at visit 1 and 2 were 133/79 and 132/78, respectively. There was an increase in percentage of patients with masked hypertension at the 3-4 month time period and a decrease in nondipping pattern. We did not identify significant differences in hemodynamic parameters between the 1 and 3 month time periods and between those with and without masked HTN.

Conclusion

In this preliminary analysis of a prospective observational study,we observed an increase in the rate of masked hypertension as patients get beyond 3 months post transplant. A significant percentage of these post transplant patients have non-dipping hypertension. Using whole body bioimpedance technology, we did not identify differences in CI, TPR and TBW between those with and without masked hypertension

 Visit 1Visit 2
Office BPN=40N=21
Normal6(15%)4(19%)
HTN34 (85%)17 (81%)
Masked HTN6/33 (18%)7/17 (44%)
White Coat HTN5/33 (15%)2/33 (12%)
Non Dipping HTN24/33 (85%)10/17 (63%)