Nocturnal nondipping hypertension is related to dyslipidemia and increased renal resistivity index in renal transplant patients.

Background: There are limited data about ambulatory blood pressure monitoring (ABPM) in renal transplantation patients. We sought to evaluate the clinical outcomes, and success of antihypertensive therapy based upon ABPM data.

Methods: We performed ABPM on 82 recipients between 2000 and 2006 including 27 females of overall age of 37.3±10.8 years who displayed mild to moderate hypertension (HT). We evaluated demographic blood pressure, proteinuria, and laboratory values, as well as renal resistive index (RRI) estimated by Doppler ultrasonography.

Results: There were 65% of subjects who were "nondippers". Nighttime systolic and diastolic blood pressures correlated with phosphorus (r=0.32; P=.04) and proteinuria (r=0.35; P=.01). The incidence of increased RRI was greater among nondipper than dipper patients (52% vs 24%; P<.01). Comparison of variables between dipping and nondipping patients were total cholesterol, low-density lipoprotein cholesterol triglyceride, and C-reactive protein values (P=.04, .03, .001, and .001, respectively). Regression analysis revealed increased RRI (<0.7) and total cholesterol (>240 mg/dL) to be the main risk factors for a nondipping pattern (P<.001 and .05 respectively).

Conclusion: Nondipping HT is common after transplantation. ABPM may be a useful tool to optimize treatment strategies to reduce cardiovascular events and chronic graft dysfunction. An high RRI seemed to be a strong determinate of nondipper status.