Routine use of ambulatory blood pressure monitoring in potential living kidney donors

Elizabeth S. Ommen, Bernd Schröppel, Jin Yon Kim, Gabrielle Gaspard, Enver Akalin, Graciella de Boccardo, Vinita Sehgal, Michael Lipkowitz, Barbara Murphy

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background and Objectives: Most transplant centers exclude prospective living kidney donors with hypertension from donation. Centers routinely identify hypertension using BP measured in the clinic, but it is not clear that clinic BP accurately detects the presence or absence of hypertension in potential donors. We therefore conducted a prospective study to determine the impact of routine ambulatory BP monitoring on diagnosis of hypertension in potential donors and the value of other baseline characteristics in predicting ambulatory BP results. Design, Setting, Participants, & Measurements: We compared classification of hypertension status by clinic BP and by ambulatory BP monitoring in 178 potential living kidney donors. Results: Of 63 individuals with hypertension by clinic BP, 62% had white-coat hypertension by ambulatory BP and were therefore eligible to donate. Of 115 individuals who were normotensive by clinic BP, 17% had masked hypertension by ambulatory BP and were excluded from donation. Individuals with masked hypertension were older, were more likely to be male, and had a somewhat higher clinic BP than individuals with sustained normotension. Individuals with white-coat hypertension had a somewhat lower clinic diastolic BP than individuals with sustained hypertension. Conclusions: Routine ambulatory BP monitoring may identify a large number of individuals with white-coat hypertension and a smaller but significant number of individuals with masked hypertension, ensuring adequate protection of potential donors and accurate assessment of donor risk. Differences in baseline characteristics are small and are not clinically useful in distinguishing individuals with masked hypertension from individuals with sustained normotension or individuals with white-coat hypertension from individuals with sustained hypertension, demonstrating the importance of ambulatory BP monitoring in this population.

Original languageEnglish (US)
Pages (from-to)1030-1036
Number of pages7
JournalClinical Journal of the American Society of Nephrology
Volume2
Issue number5
DOIs
StatePublished - Sep 2007
Externally publishedYes

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Ambulatory Blood Pressure Monitoring
Living Donors
Masked Hypertension
White Coat Hypertension
Hypertension
Kidney
Ambulatory Monitoring
Tissue Donors
Prospective Studies
Transplants

ASJC Scopus subject areas

  • Nephrology
  • Transplantation
  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Medicine(all)

Cite this

Routine use of ambulatory blood pressure monitoring in potential living kidney donors. / Ommen, Elizabeth S.; Schröppel, Bernd; Kim, Jin Yon; Gaspard, Gabrielle; Akalin, Enver; de Boccardo, Graciella; Sehgal, Vinita; Lipkowitz, Michael; Murphy, Barbara.

In: Clinical Journal of the American Society of Nephrology, Vol. 2, No. 5, 09.2007, p. 1030-1036.

Research output: Contribution to journalArticle

Ommen, ES, Schröppel, B, Kim, JY, Gaspard, G, Akalin, E, de Boccardo, G, Sehgal, V, Lipkowitz, M & Murphy, B 2007, 'Routine use of ambulatory blood pressure monitoring in potential living kidney donors', Clinical Journal of the American Society of Nephrology, vol. 2, no. 5, pp. 1030-1036. https://doi.org/10.2215/CJN.01240307
Ommen, Elizabeth S. ; Schröppel, Bernd ; Kim, Jin Yon ; Gaspard, Gabrielle ; Akalin, Enver ; de Boccardo, Graciella ; Sehgal, Vinita ; Lipkowitz, Michael ; Murphy, Barbara. / Routine use of ambulatory blood pressure monitoring in potential living kidney donors. In: Clinical Journal of the American Society of Nephrology. 2007 ; Vol. 2, No. 5. pp. 1030-1036.
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abstract = "Background and Objectives: Most transplant centers exclude prospective living kidney donors with hypertension from donation. Centers routinely identify hypertension using BP measured in the clinic, but it is not clear that clinic BP accurately detects the presence or absence of hypertension in potential donors. We therefore conducted a prospective study to determine the impact of routine ambulatory BP monitoring on diagnosis of hypertension in potential donors and the value of other baseline characteristics in predicting ambulatory BP results. Design, Setting, Participants, & Measurements: We compared classification of hypertension status by clinic BP and by ambulatory BP monitoring in 178 potential living kidney donors. Results: Of 63 individuals with hypertension by clinic BP, 62{\%} had white-coat hypertension by ambulatory BP and were therefore eligible to donate. Of 115 individuals who were normotensive by clinic BP, 17{\%} had masked hypertension by ambulatory BP and were excluded from donation. Individuals with masked hypertension were older, were more likely to be male, and had a somewhat higher clinic BP than individuals with sustained normotension. Individuals with white-coat hypertension had a somewhat lower clinic diastolic BP than individuals with sustained hypertension. Conclusions: Routine ambulatory BP monitoring may identify a large number of individuals with white-coat hypertension and a smaller but significant number of individuals with masked hypertension, ensuring adequate protection of potential donors and accurate assessment of donor risk. Differences in baseline characteristics are small and are not clinically useful in distinguishing individuals with masked hypertension from individuals with sustained normotension or individuals with white-coat hypertension from individuals with sustained hypertension, demonstrating the importance of ambulatory BP monitoring in this population.",
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