Kidney transplant: Solution or the cause of high blood pressure in kidney transplant recipients

2018 ◽  
Vol 07 ◽  
Author(s):  
Hossein Tabriziani
Keyword(s):  
Blood Pressure ◽  
Kidney Transplant ◽  
High Blood Pressure ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

scholarly journals MO105TELEMEDICAL SURVEILLANCE AND OPTIMIZED TREATMENT OF BLOOD PRESSURE IN KIDNEY TRANSPLANT RECIPIENTS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Wiebke Duettmann ◽  
Marcel Naik ◽  
Bianca Zukunft ◽  
Danilo Schmidt ◽  
Petra Glander ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Kidney Transplant ◽  
High Blood Pressure ◽  
Hypertensive Crisis ◽  
Vital Signs ◽  
Well Being ◽  
Long Term Results ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Medication Plan

Abstract Background and Aims Patients with chronic kidney disease suffer often from cardiovascular diseases, especially high blood pressure and its complications such as stroke and heart attack. After kidney transplantation, this condition persists and can in addition harm the graft. However, outpatient care surveillance is not ideal to treat high blood pressure sufficiently. mHealth solutions such as remote vital signs seem to have the potential to fill in this gap. Method To optimize the monitoring of kidney transplant recipients (KTR), the MACCS (Medical Assistant for Chronic Care Solution)-project offers participants an intensified control of home-measured vital signs via a smartphone app. Additionally, well-being and medical adherence can be forwarded. A telemedicine team reviews daily incoming data and takes action, if necessary. A self-programed telemedicine dashboard visualizes the data. KTR receive their updated medication plan and medical support. The pilot phase of project started in February 2020 and is ongoing. A randomized controlled trial will start in March 2021. The concept sticks to General Data Protection Regulation (GDPR) of European Union. Results Currently, 335 KTR participate in the project with 26 (7.76%) dropouts since beginning. Including the 26 dropouts, we received in total 15 973 blood pressure (BP) values (mmHg) (systolic BP [SBP] mean 128.56, standard deviation [SD] ±103.7, maximum (max) 220, minimum (min) 60; diastolic BP [DBP] mean 78.51, SD ±9.97, max 120, min 60) and 27 481 heart rate (HR) values in beats per minutes (bpm) (mean 70, SD ±14, max 200, min 40). For 278 times, an adaption of antihypertensive therapy took place. In total, 170/335 KTR were hospitalized, which made up for 338 hospitalizations (1.99 cases per patient, max 6, min 1), which led to 3 8547 days in hospital (mean 9.34, SD ±11.43, max 89, min 1). In 331 cases, the diagnosis (main or secondary diagnosis) was related to hypertension, and 196 cases the diagnosis may be a hypertension-related complication, e.g. myocardial infarct. Evaluation regarding significance is in process and requires further data. Conclusion mHealth solutions including remote vital signs and telemedicine personnel for regular evaluation have the potential to optimize blood pressure treatment. Acute onset of hypertensive crisis can be handled sufficiently at home and thus reduce treatment at emergency rooms. Since severe complications of high blood pressure levels manifest after years, long-term results are required to conduct conclusions.

Sex differences in ambulatory blood pressure levels, control, and phenotypes of hypertension in kidney transplant recipients

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Maria Korogiannou ◽  
Pantelis Sarafidis ◽  
Marieta P. Theodorakopoulou ◽  
Maria Eleni Alexandrou ◽  
Efstathios Xagas ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Sex Differences ◽  
Kidney Transplant ◽  
Ambulatory Blood Pressure ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

scholarly journals Correlation between Serotonin Concentration and Blood Pressure in Kidney Transplant Recipients Treated with Cyclosporine

Nephron ◽  
1996 ◽  
Vol 72 (2) ◽  
pp. 336-337 ◽  
Author(s):  
A. Azzadin ◽  
J. Malyszko ◽  
J.S. Malyszko ◽  
W. Buczko ◽  
M. Mysliwiec
Keyword(s):  
Blood Pressure ◽  
Kidney Transplant ◽  
Transplant Recipients ◽  
Serotonin Concentration ◽  
Kidney Transplant Recipients

scholarly journals BLOOD PRESSURE LEVELS DEPENDING ON THE DIFFERENCES IN THE LEVELS OF SALT INTAKE IN KIDNEY TRANSPLANT RECIPIENTS

2020 ◽  
Vol 104 (S3) ◽  
pp. S440-S440
Author(s):  
Hajime Hirano ◽  
Ryoici Maenosono ◽  
Yuya Fujiwara ◽  
Syunri Taniguchi ◽  
Hirofumi Uehara ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Kidney Transplant ◽  
Salt Intake ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

FC 127SODIUM-GLUCOSE COTRANSPORTER 2 INHIBITORS (SGLT2I) SHORT-TERM OUTCOME IN DIABETIC KIDNEY TRANSPLANT RECIPIENTS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Jude Yagan ◽  
Tarek S H Mahmoud ◽  
Osama Geith
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Kidney Transplant ◽  
Standard Of Care ◽  
Diabetic Patients ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Short Term

Abstract Background and Aims The emergence of positive data on the use of sodium glucose co-transporter inhibitors (SGLT2i) in the last several years, begged the question of whether their positive outcomes can be seen in kidney transplant recipients, as they have the same and even more pronounced cardiovascular risk factors than the general population and in addition, we got better in improving graft and patients survival in the short term , but we lack the tools to improve long term patients and graft survival where so many patients die from cardiovascular disease with a functioning graft or lose their graft from chronic changes and chronic antibody mediated rejection with difficult to control blood pressure and proteinuria For these reasons we need more powerful tools , like the SGLT2i bearing in mind the unique side effects that might be amplified in kidney transplant recipients receiving immunosuppression like urinary tract infection, and the dip in serum creatinine. Method We collected data retrospectively from transplant records of patients with type II diabetes mellitus (T2D) or post-transplant diabetes mellitus (PTDM) (n=79) who were receiving SGLT2i agents plus standard of care [SOC] management and compared them to (n=56) similar diabetic patients who were only on SOC management. Results The two groups were comparable regarding age, sex, type of donor, type of diabetes (T2D PTDM), post-transplant period, induction immunosuppression and use of CNI. Though improvement of HbA1c was not significantly different between the two groups, patients on SGLT2i showed better drop in HbA1c compared to the SOC group (0.7% versus 0.5% respectively). Reduction of BMI was equal between the two groups (-1.1%) and there was no significant difference in the number of blood pressure medications (average 2 drugs per patient). Kidney function was assessed by the eGFR using CKD-EPI equation and by urine albumin/creatinine ratio (ACR). The eGFR was calculated at start then at 1,3,6 and 12 months. In SGLT2i group, eGFR showed a dip at 3 months (from 66 to 63.35 ml/min) then started to improve gradually toward the end of the year and maintained at a level close to baseline (65.44 ml/min). The SOC group showed gradual drop in eGFR over the year from 65.76 to 63.19 ml/min. Urine ACR reduced in the SGLT2i group from 48.79 to 23.79 mg/mmol creatinine and increased from 42.84 to 63.16 mg/mmol creatinine in the SOC group. The incidences of graft rejection, urinary tract infection, genital infection, myocardial infarction, heart failure or cerebrovascular stroke were not different between the groups. Conclusion Use of SGLT2i in managing diabetic patients post kidney transplantation is safe and has better short-term outcomes on renal function with comparable safety compared to standard of care therapy.

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