Introduction

Cardiovascular complications in dialysis patients tend to decrease after kidney transplant, although they remain high when compared to general population. Dipper status on ambulatory blood pressure monitoring (ABPM) has been demonstrated to be an independent predictor factor of patient’s survival and graft outcome. On the other hand, arterial stiffness is related to cardiovascular risk in kidney transplant recipients. To date no study in kidney recipients has assessed the relationship between the dipper status and arterial stiffness.

Method

32 kidney-transplanted patients were evaluated with ABPM and with a carotid to femoral pulse wave velocity (cf-PWV) test. The tests were performed 3 to 9 months post transplant. The cf-PWV was measured with a Sphigmocor® device. All patients were on standard immunosuppressive regimen based on tacrolimus, micophenolate and steroids. On the basis of percentage reduction in the circadian BP, patients were classified into Dippers (D – ΔSBP >10%), Non-Dippers (ND – ΔSBP < 10%) and Reverse Dippers (RD – nocturnal rise in SBP).

Results

In our study the prevalence of ND status (including RD) was very high in kidney recipients.

Non Dipper patients (including RD) showed higher pulse wave velocity values than the dipper group.

Interestingly, between dipper and ND groups the age and the renal function were similar, so these possible biases on PWV were excluded.

Conclusions

In kidney transplant recipients, we found a close correlation with non-dipper status on ABPM and high pulse wave velocity.

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