The Change of Circadian Pattern of Blood Pressure in Patients with Chronic Kidney Disease Before and After Kidney Transplantation in Cipto Mangunkusumo Hospital

Abstract

Background: Circadian pattern of blood pressure (BP) is a 24 hours BP curve. Decreasing of BP 10–20% at night is called a dipper, while less than 10% a nondipper. Prevalence of hypertension and nondipper in Chronic Kidney Disease stage 5 on Dialysis (CKD 5D) are still very high. Kidney transplantation will improve BP and nondipper. Objective: To determine the change of dipper and nondipper, and the mean of 24 hours BP in CKD before, and one month after kidney transplantation. Methods: Design of the study is before and after design. 15 subjects CKD 5D before kidney transplantation, age 16–60 years, were conducted in Cipto Mangunkusumo Hospital during October to December 2014. 24 hours BP measurement were recorded with 24 hours Ambulatory Blood Pressure Monitoring in all subjects, before and one month after kidney transplantation. McNemar and t dependent test were used in statistical analysis. Results: Before kidney transplantation, 12 subjects were nondippers and 3 subjects were dippers. One month after kidney transplantation, all subjects (15) became nondippers. The decreasing of the mean of 24 hours systolic BP was found in all CKD one month after kidney transplantation, but statistically not significant (p > 0.05), while decreasing of the mean of 24 hours diastolic BP was statistically significant (p < 0.05). Conclusion: There were still no improvement in nondipper. There were a decrease in the mean of 24 hours systolic BP but not significant and a decrease in the mean of 24 hours diastolic BP significantly in patients one month after kidney transplantation.