Abstract: PO2161
Early Post Renal Transplant Hypertension: Incidence of Masked Hypertension and Hemodynamic Correlates
Session Information
- Transplantation: Clinical - Underrecognized Risk Factors, Traditional Considerations, and Outcomes
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
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 1 | Visit 2 | |
Office BP | N=40 | N=21 |
Normal | 6(15%) | 4(19%) |
HTN | 34 (85%) | 17 (81%) |
Masked HTN | 6/33 (18%) | 7/17 (44%) |
White Coat HTN | 5/33 (15%) | 2/33 (12%) |
Non Dipping HTN | 24/33 (85%) | 10/17 (63%) |