Ambulatory blood pressure monitoring prior to kidney donation - 17/04/19
Résumé |
Introduction |
In kidney transplantation (KT) the requirements for organ donation has been extended to older donors or those with a history of cardiovascular (CV) disease that previously have been considered as contraindications.
Purpose |
This study aims to determine the interest of ambulatory blood pressure monitoring ABPM prior to kidney donation.
Methods |
A descriptive retrospective study of 6 living kidney donors who underwent casual clinic and ABPM.
Results |
In our series of 73 living donor, in 67 among them, the CV evaluation of kidney donors (KD) was limited to clinic blood pressure levels. The remaining 6 KD underwent ABPM. Subjects were between the ages of 48 and 56,with a mean of body mass index of 26.5kg/m2 [22–29,5kg/m2]. The clinic systolic blood pressure (SBP) average was 138.5mmHg [114–150]. For 4 cases the ABPM was used to diagnose high blood pressure (BP). The diagnosis of hypertension was rejected in 2 patient aged<50 y.o with a clinic BP at 140/90mmHg and an ABPM daytime BP<135/85mmHg and also In 2 patient aged>50 y.o with normal BP in clinic BP measurement. The ABPM was used to check the BP balance in 2 patients whom were treated by calcium channel blocker associated to an angiotensin II receptor antagonists in one case and confirmed a well-controlled hypertension assessed by ABPM<130/85mmHg under treatment but one of them had a non-dipper hypertension. The following Table 1 details the BP measures. All of them had nephrectomy for successful KT in the recipient and simple operative follow-up for the KD.
Conclusion |
ABPM reveals white coat effect hypertension and confirm well- controlled hypertension. I should be more frequently used before and after kidney donation. The Amsterdam Forum recommend the use of an ABPM and considers that, if KD whose BP exceeds 140/90mmHg should be generally challenged, some candidates over 50 y.o whose hypertension is easily controlled without visceral repercussions may to be considered as donors.
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Vol 11 - N° 1P2
P. e302 - avril 2019 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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