Nocturnal Dipping of Blood Pressure in Renal Transplant Recipients

Abstract

Background: There is a marked diurnal variation in blood pressure (BP). Compared with daytime values, BP in most subjects is considerably lower during the night and a ‘non-dipping BP profile’ is usually defined as a nocturnal SBP fall of less than 10%. Association between non-dipper pattern of circadian rhythm of BP and impaired renal capacity was observed in some studies. A circadian non-dipping pattern is often found in renal transplant recipients, and is related to poor allograft function. Materials and Method: In this analytic-cross sectional study, 24 hours ambulatory blood pressure monitoring (ABPM) was performed in 100 renal post-transplant patients, aged >18 years old, with the serum creatinine level <2 mg/dl after one month of transplant. According to the nocturnal reduction of systolic blood pressure (SBP), dipper (SBP ≥ 10%), non-dipper (0 < SBP < 10%) and reverse dipper (SBP nocturnal rise) pattern were defined. Result: Of 100 participants of this study, 56 patients (56%) were male, and 44 patients (44%) were female. Mean age of participants was 43.34 ± 2.442 years overall, 44.27 ± 2.974 years in males and 42.16 ± 4.074 years in females. Non-dipper pattern was found in 58 patients (58%), revers dipper pattern in 35 patients (35%) and dipper pattern was found only in 7 patients (7%). The nocturnal reduction of systolic blood pressure pattern in participants regarding the gender was not significant (p = 0.794). Mean age of patients with non-dipper pattern was significantly lesser than patients with revers dipper pattern (p = 0.009), but mean age of patients with dipper pattern was not significantly different from patients with non-dipper or revers dipper pattern (p = 0.368, p = 0.605). There was no significant correlation between dipper or non-dipper or revers dipper pattern with immunosuppressive drugs(cyclosporine, tacrolimus and non calcineurin inhibitors), duration of dialysis before transplant, and the time past transplant (p = 0.194, p = 0.252, and p = 0.392, respectively). Conclusion: The revers dipper pattern was seen more frequently in older patients than younger, and there was no significant correlation between dipper or non-dipper or revers dipper pattern with immunosuppressive drugs, duration of dialysis before transplant, and the time past transplant. Urology Research Center, Guilan University of Medical Sciences.