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Pediatric Nephrology

, Volume 11, Issue 1, pp 23–26 | Cite as

Twenty-four-hour ambulatory blood pressure profiles in pediatric patients after renal transplantation

  • Nicolaus Lingens
  • Eva Dobos
  • Klaus Witte
  • Christopher Busch
  • Björn Lemmer
  • Günther Klaus
  • Karl Schärer
Original article

Abstract.

Ambulatory blood pressure monitoring was applied in 27 pediatric patients aged 6.3 – 24.3 (median 15.0) years who had been transplanted 1.5 – 8.4 years previously. Daytime values were compared with the mean of 10 concomitant casual blood pressure recordings. At the time of the study, antihypertensive drugs were given to 17 patients. Inulin clearance ranged from 18 to 116 (median 66) ml/min per 1.73 m2. Ambulatory blood pressure monitoring confirmed hypertension or normotension determined by casual blood pressure measurements in 63% of patients. The physiological nocturnal dip in blood pressure was attenuated or reversed in 8 of 27 patients. It was reduced in all 3 patients with renal artery stenosis of the graft, in 3 of 4 patients with chronic rejection, in the only patient with recurrent focal segmental glomerulosclerosis, and in 1 of 6 patients with past acute rejection. The dipping was not related to inulin clearance. In conclusion, casual blood pressure measurements do not accurately reflect blood pressure in pediatric patients transplanted more than 1.5 years previously. A reduced nocturnal dip in blood pressure may indicate an underlying renovascular or renoparenchymal pathology. Ambulatory blood pressure monitoring should regularly be applied in patients with renal transplants.

Key words: Ambulatory blood pressure monitoring Circardian rhythm Renal transplantation 

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Copyright information

© IPNA - International Pediatric Nephrology Association New York, USA 1997

Authors and Affiliations

  • Nicolaus Lingens
    • 1
  • Eva Dobos
    • 1
  • Klaus Witte
    • 2
  • Christopher Busch
    • 3
  • Björn Lemmer
    • 2
  • Günther Klaus
    • 1
  • Karl Schärer
    • 1
  1. 1.Division of Pediatric Nephrology, University Children’s Hospital, Heidelberg, GermanyDE
  2. 2.Institute of Pharmacology and Toxicology, Faculty of Clinical Medicine, University of Heidelberg, Mannheim, GermanyDE
  3. 3.Institute of Medical Statistics, Hamburg, GermanyDE

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