gms | German Medical Science

27. Wissenschaftlicher Kongress der Deutschen Hochdruckliga

Deutsche Liga zur Bekämpfung des hohen Blutdrucks – Deutsche Hypertonie Gesellschaft e. V.

26. bis 29.11.2003, Bonn

Article

Send article

Elevated pulse pressure in renal allograft recipients is associated with reduced allograft survival and higher recipient age

Erhöhter Pulsdruck ist mit einem reduzierten Nierentransplantatsurvival assoziiert

Meeting Abstract (Hypertonie 2003)

Search Medline for

  • presenting/speaker J. Beige - Berlin, D
  • P. Martus - Berlin, D
  • T. Maier - Berlin, D
  • R. Kreutz - Berlin, D
  • G. Offermann - Berlin, D
  • W. Zidek - Berlin, D

Hypertonie 2003. 27. Wissenschaftlicher Kongress der Deutschen Hochdruckliga. Bonn, 26.-29.11.2003. Düsseldorf, Köln: German Medical Science; 2004. Doc03hochV19

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hoch2003/03hoch019.shtml

Published: November 11, 2004

© 2004 Beige et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Pulse pressure (PP) has been shown to be a powerful marker of cardiovascular risk in macrovascular conditions. Worsening of kidney allograft function can be regarded as a microvascular condition accelerated by immunological risk. Although post-transplant hypertension has been recognized as the most powerful risk factor for decreased renal allograft survival, no data have been provided examining the particular impact of PP on graft survival. Therefore, we aimed to elucidate the effect of PP one year post Tx on graft survival, as a model for microvascular diseases.

One year blood pressure (BP) levels of patients transplanted in Berlin-Steglitz between 1981 and 2002 were retrieved from clinical records. BP measurements were performed at home or by nurses before doctor´s visit. Survival data were followed prospectively by transplant coordinators.

Multiple Cox hazard regression adjusting for covariates revealed a significant and independent association association between donor age and graft survival (p<0.0001) as well as pulse pressure and graft survival (p=0.0001) while the association of systolic BP and graft survival was dependent from pulse pressure. Pulse pressure was significantly associated with recipient (p<0.0001) and donor age (p=0.0008) and donor gender (p=0.02).

The already known relationship between BP and graft survival is dependent from elevated pulse pressure. Therefore, we could show for the first time in a prospective clinical study, that pulsatile stress in terms of elevated PP is a risk factor in not only macrovascular diseases but in microvascular conditions as well. In kidney Tx, elucidation of patients exhibiting high pulse/normal systolic BP is of high demand to identify inappropriate antihypertensive therapy. Furthermore, PP is a risk marker of high impact that can guide the dissection of benefits of particular antihypertensive regimes in renal transplantation.

[Fig. 1]