Hypertension in Renal Transplant Patients: A Prospective Descriptive and Analytical Study

Abstract

The prevalence of hypertension in kidney transplant patients is significant. The physiological circadian evolution of blood pressure (BP) shows a nocturnal decrease of 10 to 20%, called dipping rate. According to this dipping rate, several profiles have been determined, some of which were correlated with the occurrence of cardiovascular events. We set two main objectives for this study: to evaluate the prevalence of hypertension in kidney transplant patients and to determine the dipping rate of hypertensive transplant patients in our series, and its impact on albuminuria. 62 renal transplant patients were included in this study. They underwent 24-hour ambulatory blood pressure measurement (ABPM) with the Suntech AccuWin Pro device in a nephrology department. Arterial hypertension (AH) and dipper status were defined according to the 2018 European Society of Cardiology (ESC) recommendations. A Mann Whitney test assessed the impact of dipper status on albuminuria. The prevalence of hypertension was 52% in a population with a median age of 44 years; 67% of patients had albuminuria >30 mg/24 hours. 3% of hypertensive patients were dippers, 42% of patients were nondippers, and 6% of patients were reverse dippers. A correlation between albuminuria and reverse dipper profile was found with a p = 0.044. In renal transplant recipients, arterial hypertension is a major risk factor of graft loss.  Blood pressure control in our population is suboptimal, especially in a population where the impact of nocturnal hypertension on markers of renal damage is well documented.