gms | German Medical Science

28. Wissenschaftlicher Kongress der Deutschen Hochdruckliga

24. bis 27.11.2004, Hannover

Blood Pressure Screening by 24h-ABPM and Office Measurements During Long Term Follow-up After Kidney Transplantation

Vorteile von Praxisblutdruck und 24h-ABDM im Langzeitverlauf nach Nierentransplantation

Meeting Abstract (Hypertonie 2004)

Suche in Medline nach

  • S. Bocker - Klinik für Innene Medizin III (Jena, D)
  • J. Bohlender - Klinik für Innene Medizin III (Jena, D)
  • G. Stein - Klinik für Innene Medizin III (Jena, D)

Hypertonie 2004. 28. Wissenschaftlicher Kongress der Deutschen Hochdruckliga. Hannover, 24.-27.11.2004. Düsseldorf, Köln: German Medical Science; 2005. Doc04hochP113

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Veröffentlicht: 10. August 2005

© 2005 Bocker et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen ( Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.



Aim: After kidney transplantation it is still open whether casual office blood pressure measurements (casBP) can replace 24h-ambulatory BP monitoring (ABPM). We compared the predictive value of casual BP levels with 24h-ABPM in these patients.

Methods: We retrospectively analysed 104 out-patients who had received a renal allograft (Tx) for end-stage renal disease during 1995 and 1996. Data for 6 years follow up after Tx were included and patients had at least two ABPM measurements. A standardized protocol was used to average 2-4 casBPs during n=12 time intervals post Tx and results were compared with ABPM. Normal BP limits were 140/90 mm Hg for casBP and 125/80 for average ABP. Descriptive and tabulated statistics were calculated.

Results: The cohort's mean characteristics at Tx were: age 48±13 y, 35% female, 6% diabetics, 13% living kidney donor, BMI 24±3 m2/kg panel reactivity 3±10%, HLA mismatch 3.4±1.3, CyclosporineA 88.9%, serum creatinine (CREA) 3 mo after Tx 113±26 umol/l. Mean casBP after Tx was 144/84 mm Hg with 144/85 for day time mean ABP and similar night time and average ABPs. Thereafter mean systolic and diastolic casBP levels were 6-10 and 1-5 mm Hg higher compared with ABPM until 6 y post Tx (p<0.05) when casBP steadily fell to 135/82 and day time ABPM to 126/77 mm Hg. CREA was not a predictor of casBP or ABP levels at any time (r<0.35; p=NS). Average correlation for day systolic casBP and ABP was 0.40±0.15 (p<0.05) with similar results for other BP components, indpendent of time post Tx. Longitudinal correlation was 0.82 between methods. Sensitivity of casBP to predict ABPM hypertension was 60-70% and specitivity 0.80-0.90.

Conclusion: casBP levels overestimated BP compared with ABPM while correlating only moderately. Instead, sensitivity and specificity to detect persistent hypertension was good. Depending on treatment aims, a differential approach to BP screening appears necessary in patients with renal Tx.