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Relationship between diurnal blood pressure and renal histopathological changes in white coat hypertension

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Abstract

Background

Multiple epidemiological studies have clearly demonstrated the macrovascular risks associated with white coat hypertension (WCH) or sustained hypertension (SH). In patients with WCH, there is no literature available on renal histopathological changes and that on blood pressure pattern and native kidney outcome is scant. We aimed to clarify the relationship between blood pressure variables and pathological features of kidney biopsies in living kidney donors with WCH.

Methods

This cross-sectional study included living kidney donors with WCH (n = 10) and SH (n = 10), and 20 healthy kidney donors with similar demographic features (control group). Kidney allograft biopsy samples were obtained during transplantation and chronic glomerular, vascular and tubulointertitial changes were semiquantitatively scored according to the Banff classification.

Results

The mean age of the 20 hypertensive subjects (Group 1) and controls (Group 2) was 59.3 ± 8.5 versus 59.6 ± 7.6 years and almost half were female. There was no difference in renal function parameters between the groups; however, kidney histopathology in Group 1 was worse than Group 2 with a chronicity index of 2.80 ± 1.67 versus 1.75 ± 1.16 (p = 0.02). There was no difference between histopathological scores of patients with WCH or SH (chronicity index: 2.60 ± 1.43 vs. 2.70 ± 1.70, p = 0.88). Night-to-day mean arterial pressure (MAP) ratio was significantly associated with chronicity index in patients with WCH. Moreover, WCH patients with non-dipper hypertensive pattern had a worse chronicity index.

Conclusions

Significant histopathological alterations in the kidney were observed in patients with WCH and SH, and were accentuated in WCH patients with non-dipper blood pressure pattern.

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Acknowledgements

This study did not receive any financial support.

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Authors and Affiliations

  1. Department of Nephrology, Izmir Bozyaka Education and Research Hospital, Karabaglar, +9035170, Izmir, Turkey

    Erhan Tatar

  2. Department of General Surgery, Izmir Bozyaka Education and Research Hospital, Izmir, Turkey

    Adam Uslu & Murat Karatas

  3. Department of Pathology, Izmir Bozyaka Education and Research Hospital, Izmir, Turkey

    Funda Tasli

Authors
  1. Erhan Tatar
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  2. Adam Uslu
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  3. Funda Tasli
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  4. Murat Karatas
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Correspondence to Erhan Tatar.

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Ethical approval

The protocol for the study was approved by a suitably constituted Ethics Committee of the institution within which the work was undertaken and the study conformed to the provisions of the Declaration of Helsinki.

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Informed consent was obtained from all participants included in the study.

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Tatar, E., Uslu, A., Tasli, F. et al. Relationship between diurnal blood pressure and renal histopathological changes in white coat hypertension. J Nephrol 30, 551–556 (2017). https://doi.org/10.1007/s40620-017-0382-1

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  • DOI: https://doi.org/10.1007/s40620-017-0382-1

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