%0 Journal Article
%T Blood Pressure and Pulse Pressure in Renal Transplantation
%A J. Beige
%A T. Maier
%A P. Martus
%A I. Moosmayer
%J Transplantationsmedizin
%D 2004
%I Pabst Science Publishers
%X Background: The impact of pulse pressure on cardiovascular mortality has been elucidated in essential hypertension by means of large epidemiological studies. In renal transplantation, one short report has been published showing an association of pulse pressure with cardiovascular mortality as well. However, common covariates in renal transplantation were not considered comprehensively and renal allograft survival was not studied. Methods: Mono-centric, cross-sectional observational study to elucidate the association of baseline blood pressure, pulse pressure and renal allograft function with prospective follow-up of graft and patient survival. Findings: In univariate analyses, systolic blood pressure and pulse pressure were both associated with graft (p=0.02, p=0.07 resp.) and patient survival (p=0.02, p=0.01 resp.). Multivariate analyses elucidated an independent association of systolic BP with isolated graft loss (censored for patient death, p=0.05) and an independent association of pulse pressure with overall graft loss (including loss by patient death, p=0.005). The univariate associations of pulse and sys BP with patient survival disappeared after multivariate correction for underlying disease, recipient age and donor age. Interpretation: Pulse and systolic blood pressure exhibit a different pathophysiological impact in renal transplantation. While elevated pulse pressure seems to be associated with increased mortality, systolic blood pressure is one of a few independent markers of graft loss in surviving recipients. Goals of therapeutic interference with both pulse and blood pressure have to be dissected in frame of an comprehensive description of risk markers and underlying conditions in renal transplantation.
%K transplantation
%K renal
%K kidney
%K hypertension
%K post-transplant hypertension
%K pulse pressure
%K kidney allograft survival
%K graft survival
%K mortality
%K patient survival
%U http://www.transplantation.de/fileadmin/transplantation/txmedizin/txmedizin_2004_2/Beige.pdf