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Background <p>Post-kidney transplant arterial hypertension (HTN) is a very common complication that deteriorates grafts, shortens their lifespan, and involves an increased risk of cardiovascular complications.</p> Methods <p>Retrospective observational study in 62 kidney transplant patients (60% deceased donor, 26% pre-dialysis transplant) aged between 4 and 18&#xa0;years, with a median post-transplant time of 5&#xa0;years. Blood pressure (BP) was measured during consultations; ambulatory blood pressure monitoring (ABPM) was performed, along with blood and urine analysis, echocardiography, and kidney ultrasound.</p> Results <p>Of the 62 patients evaluated, 27 (44%) were receiving antihypertensive treatment. ABPM detected hypertension in 25 patients (40%), of whom 11 (41%) were already on treatment. Fifteen patients (24%) presented with masked hypertension. Younger patients showed a significantly higher prevalence of abnormal ABPM findings (<i>p</i> = 0.011). Truly normotensive patients received lower doses of corticosteroids and exhibited a lower prevalence of overweight and left ventricular hypertrophy (LVH) compared with the other groups (controlled, uncontrolled, and untreated). Seventy-three percent of patients exhibited a loss of physiological nocturnal dipping. LVH (24%) was influenced by ambulatory systolic blood pressure and the presence of prior rejection (<i>p</i> = 0.016). Loss of systolic dipping significantly contributed to the presence of LVH in the multivariate analysis (OR, 0.829; <i>p</i> = 0.033).</p> Conclusions <p>Our cohort shows poor BP control (masked HTN detected in 1 out of every 4 patients). Effective control of systolic BP appears to be crucial in preventing LVH. Our findings support the routine use of ABPM in pediatric transplant recipients, even in those under antihypertensive treatment.</p> Graphical Abstract <p></p>

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Circadian blood pressure patterns in kidney transplant recipients assessed by ambulatory blood pressure monitoring

  • 期刊论文

  • 发表日期：

    2026年1月10日

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  • Manuel Vaqueiro Graña,
  • Juan Bravo Feito,
  • Laura García Espinosa,
  • Marta Melgosa Hijosa,
  • Alejandro Zarauza Santoveña,
  • Carlota Fernández Camblor,
  • Diego Morante Martínez,
  • Ángel Alonso Melgar,
  • Miriam Muñoz Berges,
  • Beatriz Calderón Cruz,
  • Laura Espinosa Román

摘要

Background

Post-kidney transplant arterial hypertension (HTN) is a very common complication that deteriorates grafts, shortens their lifespan, and involves an increased risk of cardiovascular complications.

Methods

Retrospective observational study in 62 kidney transplant patients (60% deceased donor, 26% pre-dialysis transplant) aged between 4 and 18 years, with a median post-transplant time of 5 years. Blood pressure (BP) was measured during consultations; ambulatory blood pressure monitoring (ABPM) was performed, along with blood and urine analysis, echocardiography, and kidney ultrasound.

Results

Of the 62 patients evaluated, 27 (44%) were receiving antihypertensive treatment. ABPM detected hypertension in 25 patients (40%), of whom 11 (41%) were already on treatment. Fifteen patients (24%) presented with masked hypertension. Younger patients showed a significantly higher prevalence of abnormal ABPM findings (p = 0.011). Truly normotensive patients received lower doses of corticosteroids and exhibited a lower prevalence of overweight and left ventricular hypertrophy (LVH) compared with the other groups (controlled, uncontrolled, and untreated). Seventy-three percent of patients exhibited a loss of physiological nocturnal dipping. LVH (24%) was influenced by ambulatory systolic blood pressure and the presence of prior rejection (p = 0.016). Loss of systolic dipping significantly contributed to the presence of LVH in the multivariate analysis (OR, 0.829; p = 0.033).

Conclusions

Our cohort shows poor BP control (masked HTN detected in 1 out of every 4 patients). Effective control of systolic BP appears to be crucial in preventing LVH. Our findings support the routine use of ABPM in pediatric transplant recipients, even in those under antihypertensive treatment.

Graphical Abstract