P1682POST-TRANSPLANT VISIT-TO-VISIT PULSE PRESSURE VARIABILITY AND RISK OF RENAL ALLOGRAFT FUNCTION DECLINE

Abstract

Abstract Background and Aims Pulse pressure (PP) is associated with risk of kidney disease. Association between visit-to-visit PP variability (VVPPV) and renal allograft outcomes is unknown. Method VVPPV, variation of PP between each consecutive BP measurement at 4, 12, 24, 36, and 48 weeks after kidney transplantation (KT), was determined by using coefficient of variation (CV = SD/Mean x 100%). VVPPV was then categorized into 12 strata (<5, 5 - <10, 10 - <15, 15 - <20, 20 - <25, 25 - <30, 30 - <35, 35 - <40, 40 - <45, 45 - <50, 50 - <55, and ≥55). Association between the categorized VVPPV and progression of renal allograft function, which was defined by a decrease in estimated glomerular filtration rate (eGFR) after 12-week post-KT, was examined by Cox proportional hazard regression analysis. Results Of all 102 renal transplant recipients from a single kidney transplant center, mean age±SD was 54.16±11.73 years and 63 patients (62%) was female. An incidence rate of worsening renal allograft function after 12-week post-KT was 0.017 person-weeks with a median survival time of 36 weeks (Figure 1). Every 5% increase in CV of PP was associated with a 14% increased risk of worsening post-transplant eGFR (hazard ratio (HR) 1.142431, 95% confidence interval (CI) 0.9999617 to 1.305199, and p value 0.050). After adjusted for age, gender, types of induction immunosuppressive medications, pretransplant body mass index category, every increase in 5% CV of PP was significantly associated with a 16% greater risk of worsening post-transplant eGFR (HR 1.160975, 95% CI 1.007967 to 1.337209, and p value 0.038). Conclusion VVPPV is an independent predictor of worsening renal allograft function.