Open AccessAssessment of the 24-hour profle of blood pressure and arterial stiffness in patients with end-stage renal disease
Author(s) -
Irina Minyukhina,
E. A. Praskurnichiy
Publication year - 2019
Publication title -
arterialʹnaâ gipertenziâ
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.126
H-Index - 5
eISSN - 2411-8524
pISSN - 1607-419X
DOI - 10.18705/1607-419x-2019-25-1-66-73
Subject(s) - medicine , arterial stiffness , blood pressure , end stage renal disease , pulse wave velocity , transplantation , cutoff , cardiology , hemodialysis , pulse pressure , kidney transplantation , surgery , urology , physics , quantum mechanics
Objective. The purpose of our study was to research specifc features the daily changes of the vascular stiffness (VS) in patients with end-stage renal disease (ESRD) and to assess the feasibility of using the 24-hour vascular index Pulse Time Index of Norm (PTIN) (the percentage of the 24-hour period during which the pulse wave velocity (PWVao) does not exceed 10 m/second) in the management of arterial hypertension (HTN) in patients after renal transplantation (RT). Design and methods. We examined 158 people, divided into 4 comparable age groups: those receiving program hemodialysis (PGD), patients after RT, patients with essential HTN and healthy volunteers. All of them underwent 24-hour blood pressure (BP) monitoring with a daily evaluation of VS indices and central BP. At follow-up, 27 patients from the PG group underwent all assessments also 1 week and 6 months after transplantation. Results. Patients with ESRD compared with patients with essential HTN had elevated PWVao, night central BP and decrease PTIN. PTIN changes were the most signifcant. In 27 patients a week after the RT a decrease in the PTIN was found in most cases. After 6 months the mean PTIN in the whole group increased again. Our study demonstrates HTN persistence after kidney transplantation can be predicted. Two PTIN states could be predicted by the cutoff PTIN value that was determined in the study: a state of improvement and a state of decline/unchanged state. PTIN cutoff value at 45 % was characterized by 69 % sensitivity, 76 % specifcity and AUC of 0,65. Therefore, baseline PTIN ≥ 45 % (before RT) is associated with its further growth, and a favourable course of HTN. Conclusions. Patients receiving replacement therapy, compared to patients with essential HTN, showed a marked increase in the daily VS and the night central BP. The daily PTIN is the most accurate predictor of the changes in the VS index, the PTIN values before the RT at the PG stage allow predicting the course of HTN after the RT