Ambulatory blood pressure monitoring prior to kidney donation

Abstract

In kidney transplantation (KT) the requirements for organ donation has been extended to older donors or those with a history of cardiovascular (CV) disease that previously have been considered as contraindications. This study aims to determine the interest of ambulatory blood pressure monitoring ABPM prior to kidney donation. A descriptive retrospective study of 6 living kidney donors who underwent casual clinic and ABPM. In our series of 73 living donor, in 67 among them, the CV evaluation of kidney donors (KD) was limited to clinic blood pressure levels. The remaining 6 KD underwent ABPM. Subjects were between the ages of 48 and 56,with a mean of body mass index of 26.5 kg/m 2 [22–29,5 kg/m 2 ]. The clinic systolic blood pressure (SBP) average was 138.5 mmHg [114–150]. For 4 cases the ABPM was used to diagnose high blood pressure (BP). The diagnosis of hypertension was rejected in 2 patient aged < 50 y.o with a clinic BP at 140/90 mmHg and an ABPM daytime BP < 135/85 mmHg and also In 2 patient aged > 50 y.o with normal BP in clinic BP measurement. The ABPM was used to check the BP balance in 2 patients whom were treated by calcium channel blocker associated to an angiotensin II receptor antagonists in one case and confirmed a well-controlled hypertension assessed by ABPM < 130/85 mmHg under treatment but one of them had a non-dipper hypertension. The following Table 1 details the BP measures. All of them had nephrectomy for successful KT in the recipient and simple operative follow-up for the KD. ABPM reveals white coat effect hypertension and confirm well- controlled hypertension. I should be more frequently used before and after kidney donation. The Amsterdam Forum recommend the use of an ABPM and considers that, if KD whose BP exceeds 140/90 mmHg should be generally challenged, some candidates over 50 y.o whose hypertension is easily controlled without visceral repercussions may to be considered as donors.