LONG TERM FOLLOW UP OF HYPERTENSIVE PATIENTS WITH ATHEROSCLEROSIS RENAL ARTERY STENOSIS AFTER PERCUTANEOUS RENAL ARTERY ANGIOPLASTY OR STENTING: BLOOD PRESSURE OUTCOME: 4B.05

Abstract Background: Transplant Renal Artery Stenosis (TRAS) is the main vascular complication of kidney transplantation. For research and treatment purposes, several authors consider critical renal artery stenosis to be greater than 50%, and percutaneous intervention is indicated in this scenario. However, there are no reports in the current literature on the evolution of patients with less than 50% stenosis.Method: Retrospective study includes data from all patients that were submitted to kidney transplantation and were suspected TRAS after transplantation with stenosis under 50% independent on age, who were referred for angiography at a single center between January 2007 and December 2014. Results: During this period, 6,829 kidney transplants were performed at Hospital do Rim, 313 of them had clinical suspicion of TRAS and 54 were those who presented no-significant stenosis. The average age was 35.93 years old, the predominant gender was male and most individuals (94.4%) were submitted to dialysis before transplantation. Transplants, in most cases in this group, occurred from a deceased donor, 66.7%. The time between transplantation and angiography was less than one year in 79.6% of patients and all presented no-significant TRAS. Creatinine levels, Systolic Blood Pressure, Diastolic Blood Pressure and the glomerular filtration rate improved over the long term. The outcomes found were death and renal loss.Conclusion: Age, sex and ethnic group of patients are factors that did not interfere with the frequency of renal artery stenosis. The outcomes showed that in the long term most patients evolve well, and have improved quality of life and kidney function, although there are cases of death and kidney loss.

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The Prognostic Effect of Circadian Blood Pressure Pattern on Long-Term Cardiovascular Outcome Is Independent of Left Ventricular Remodeling

Journal of Clinical Medicine ◽

10.3390/jcm8122126 ◽

2019 ◽

Vol 8 (12) ◽

pp. 2126 ◽

Cited By ~ 5

Author(s):

Marijana Tadic ◽

Cesare Cuspidi ◽

Vera Celic ◽

Biljana Pencic ◽

Giuseppe Mancia ◽

...

Keyword(s):

Blood Pressure ◽

Ventricular Remodeling ◽

Left Ventricular Remodeling ◽

Myocardial Revascularization ◽

Left Ventricular ◽

Hypertensive Patients ◽

Long Term Follow Up ◽

Reverse Dipping

We aimed to investigate the predictive value of 24 h blood pressure (BP) patterns on adverse cardiovascular (CV) outcome in the initially untreated hypertensive patients during long-term follow-up. This study included 533 initially untreated hypertensive patients who were involved in this study in the period between 2007 and 2012. All participants underwent laboratory analysis, 24 h BP monitoring, and echocardiographic examination at baseline. The patients were followed for a median period of nine years. The adverse outcome was defined as the hospitalization due to CV events (atrial fibrillation, myocardial infarction, myocardial revascularization, heart failure, stroke, or CV death). During the nine-year follow-up period, adverse CV events occurred in 85 hypertensive patients. Nighttime SBP, non-dipping BP pattern, LV hypertrophy (LVH), left atrial enlargement (LAE), and LV diastolic dysfunction (LV DD) were risk factors for occurrence of CV events. However, nighttime SBP, non-dipping BP pattern, LVH, and LV DD were the only independent predictors of CV events. When all four BP pattern were included in the model, non-dipping and reverse dipping BP patterns were associated with CV events, but only reverse-dipping BP pattern was independent predictor of CV events. The current study showed that reverse-dipping BP pattern was predictor of adverse CV events independently of nighttime SBP and LV remodeling during long-term follow-up. The assessment of BP patterns has very important role in the long-time prediction in hypertensive population.

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