Hypertension is common in the post transplant period. A few studies in adults have demonstrated an association between nocturnal hypertension and poor renal and cardiovascular outcomes. A relationship between abnormal dipping patterns and cardiovascular morbidity has also been shown. However, an association between the non-dipping pattern and renal outcomes has not been firmly established.

We hypothesized that an abnormal dipping pattern would be associated with worse allograft function in children with a kidney transplant.

Ambulatory BP monitoring (ABPM) data from 30 pediatric renal transplant recipients aged between 3 and 17 were retrospectively evaluated to determine the relationship between dipping profiles and allograft function measured by iothalamate GFR (iGFR), which is standard of care in our program at 1 year post-transplant.

The median length of follow-up was 1199 (100- 4576) days. 27 patients had completed a 1-year follow-up. The average iGFR at 1 year was 81.6 +/- 22.7ml/min/m2. A normal dipping pattern was seen in 53.6% (15/28) patients. There was no significant correlation between an abnormal dipping pattern and decreased allograft function (r2= -0.058; p-value= 0.794), even after adjustment for treatment with antihypertensive medication and deceased donor source.

This study did not demonstrate an association between non-dipping status and allograft dysfunction which is consistent with other studies that have shown that the absolute nocturnal blood pressure load is a stronger predictor of allograft dysfunction than the dipping status. A larger study is needed to confirm these findings.

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