| Abstract | Cilj istraživanja:
Cilj ovog istraživanja bio je opisati osobitosti arterijske hipertenzije (AH) kod bolesnika
s transplantiranim bubregom i AH koji su snimili KMAT u razdoblju od siječnja 2019. do
veljače 2023. godine na Zavodu za nefrologiju i dijalizu, Klinike za unutarnje bolesti, Kliničkog
bolničkog centra Split.
Ispitanici i postupci:
Provedeno je retrospektivno istraživanje na 87 ispitanika s transplantiranim bubregom.
Za svakog ispitanika zabilježeni su: dob, spol, duljina liječenja dijalizom prije transplantacije
bubrega (Tx) (mjeseci), vrijeme proteklo od Tx (mjeseci), podatak o postojanju AH, šećerne
bolesti, kardiovaskularnih bolesti, cerebrovaskularnih bolesti, o uzimanju antihipertenzivne
terapije, o vrsti antihipertenzivne terapije, o broju antihipertenzivnih lijekova te podatak o
modalitetu dijaliznog liječenja prije Tx. Također, prikazani su laboratorijski podatci ispitanika
i vrijednosti dobivene KMAT-om izraženi kao prosječne ukupne te dnevne i noćne vrijednosti
sistoličkog i dijastoličkog tlaka (mmHg), srednjeg arterijskog tlaka (engl. Mean Arterial
Pressure, MAP) (mmHg) i tlaka pulsa (engl. Pulse Pressure, PP) (mmHg).
Rezultati:
U istraživanje je uključeno ukupno 87 ispitanika, 52 muškaraca i 35 žena. Medijan dobi
svih ispitanika je 61 godina (interkvartilnog raspona od 50 do 67 godina) u rasponu od 26 do
76 godina. Najzastupljeniji antihipertenzivi bili su blokatori kalcijskih kanala i beta blokatori,
a svaki od njih koristilo je 62 (80,5%) ispitanika. Tri ili više antihipertenzivna lijeka koristilo je
63 (81,8%), dok je 76 ispitanika (87,35%) imalo vrijednosti AT ≥ 130/80 mmHg. ACEi koristilo
je 19 (24,7%), a ARB 4 (5,2%) ispitanika. Oboljeli od šećerne bolesti imali su statistički
značajno niže medijane vrijednosti dijastoličkog AT tijekom 24 h (P = 0,002) i tlaka pulsa
tijekom 24 (P = 0,001).
Zaključak:
Bolesnici s transplantiranim bubregom imaju visoku učestalost neregulirane i
rezistentne arterijske hipertenzije. Oboljeli od šećerne bolesti imaju viši PP kao marker krutosti
krvnih žila i predstavljaju posebno rizičnu populaciju bolesnika s Tx i AH. |
| Abstract (english) | Introduction:
The aim of this study was to describe the characteristics of arterial hypertension in
kidney transplant recepients who underwent 24h ABPM in the period from January 2019 to
February 2023 at the Department of Nephrology and Dialysis, Clinic for Internal Diseases,
University Hospital of Split.
Subjects and methods:
The study was conducted on 87 kidney transplant recepients. The main investigated
parameters for each patient were: age, gender, duration of the renal replacement therapy
(months), time elapsed since the kidney transplantation (months), history of arterial
hypertension, diabetes, cardiovascular and cerebrovascular diseases, data about
antihypertensive therapy, type of antihypertensive therapy, number of antihypertensive drugs
taken and dialysis modality. Furthermore, values of laboratory parameters and average total,
daily and nightly values of systolic and diastolic (mmHg), mean arterial pressure (mmHg) and
pulse pressure (mmHg) were recorded. All data were collected after kidney transplantation and
within a period of 6 months from the recording of 24h ABPM.
Results:
Total of 87 patients were included in this study, 52 males and 35 females. The median
age was 61 years (IQR from 50 to 67), in the range from 26 to 76 years. All of the patients have
had history of arterial hypertension and were using antihypertensive drugs. The most commonly
used antihypertensive drugs were calcium channel blockers and beta blockers and each one of
them was used by 62 (80,5%) patients. Three or more antihypertensive drugs were used by 63
(81,8%) out of 77 patients, while 76 (87,35%) had arterial pressure values ≥ 130/80 mmHg.
Diabetic patients had statistically significant lower median values of a total diastolic arterial
pressure (P = 0,002) and of a total pulse pressure values (P = 0,001). Patients with diabetes had
statistically significant lower median values of diastolic AT during 24 h (P = 0.002) and pulse
pressure during 24 h (P = 0.001).
60
Conclusion:
Kidney transplant recepients have a high frequency of unregulated and resistant arterial
hypertension. Patients with diabetes have higher PP as a marker of blood vessel stiffness and
represent a particularly risky population of patients with Tx and AH. |
