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See detailUrinary and dietary sodium and potassium associated with blood pressure control in treated hypertensive kidney transplant recipients: an observational study
Saint-Remy, Annie ULg; SOMJA, Mélanie ULg; Gellner, Karen et al

in BMC Nephrology (2012), 13

Background In kidney transplant (Kt) recipients, hypertension is a major risk for cardiovascular complications but also for graft failure. Blood pressure (BP) control is therefore mandatory. Office BP ... [more ▼]

Background In kidney transplant (Kt) recipients, hypertension is a major risk for cardiovascular complications but also for graft failure. Blood pressure (BP) control is therefore mandatory. Office BP (OBP) remains frequently used for clinical decisions, however home BP (HBP) have brought a significant improvement in the BP control. Sodium is a modifiable risk factor, many studies accounted for a decrease of BP with a sodium restricted diet. Increased potassium intake has been also recommended in hypertension management. Using an agreement between office and home BP, the present study investigated the relations between the BP control in Kt recipients and their urinary excretion and dietary consumption of sodium and potassium. Methods The BP control defined by OBP <140/90 mmHg and HBP <135/85 mmHg was tested in 70 Kt recipients (mean age 56 +/- 11.5 years; mean graft survival 7 +/- 6.6 years) treated with antihypertensive medications. OBP and HBP were measured with a validated oscillometric device (Omron M6(R)). The 24-hour urinary sodium (Na+) and potassium (K+) excretions as well as dietary intakes were compared between controlled and uncontrolled (in office and at home) recipients. Non parametric Wilcoxon Mann--Whitney Test was used for between groups comparisons and Fisher's exact test for frequencies comparisons. Pearson correlation coefficients and paired t-test were used when sample size was >30. Results Using an agreement between OBP and HBP, we identified controlled (21%) and uncontrolled recipients (49%). Major confounding effects susceptible to interfere with the BP regulation did not differ between groups, the amounts of sodium excretion were similar (154 +/- 93 vs 162 +/- 88 mmol/24 h) but uncontrolled patients excreted less potassium (68 +/- 14 vs 54 +/- 20 mmol/24 h; P = 0.029) and had significantly lower potassium intakes (3279 +/- 753 vs 2208 +/- 720 mg/24 h; P = 0.009), associated with a higher urinary Na+/K + ratio. Systolic HBP was inversely and significantly correlated to urinary potassium (r = -0.48; P = 0.002), a positive but non significant relation was observed with urinary sodium (r = 0,30;P = 0.074). Conclusions Half of the treated hypertensive Kt recipients remained uncontrolled in office and at home. Restoring a well-balanced sodium/potassium ratio intakes could be a non pharmacological opportunity to improve blood pressure control. [less ▲]

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See detailContrôle de la pression artérielle (PA) et mesure de la rigidité artérielle (RA) chez des transplantés rénaux (TR) (étude EPARA)
Gellner, Karen; Saint-Remy, Annie ULg; BONVOISIN, Catherine ULg et al

in Archives des Maladies du Coeur et des Vaisseaux (2011, December), Hors série 3

EPARA a étudié le contrôle de la PA au cabinet de consultation et en dehors, et l'état de rigidité artérielle chez des transplantés rénaux stables, greffés depuis plus d'un an. Le contrôle de la PA est ... [more ▼]

EPARA a étudié le contrôle de la PA au cabinet de consultation et en dehors, et l'état de rigidité artérielle chez des transplantés rénaux stables, greffés depuis plus d'un an. Le contrôle de la PA est loin d‘être satisfaisant dans cette population de TR hypertendus, traîtés pour la plupart, particulièrement à domicile. L‘HTA masquée est fréquente, associée à un risque cardio-vasculaire élevé et une rigidité accrue des grosses artères. La PAS centrale est d‘autant plus élevée que la fonction rénale est mauvaise. Proposer de recourir systématiquement à des mesures ambulatoires de PA est hautement conseillé chez ce type de patients! [less ▲]

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See detailReproducibility of blood pressure (BP) measurement techniques in late kidney transplantation (KT): the EPARA study
Gellner, Karen; Saint-Remy, Annie ULg; WEEKERS, Laurent ULg et al

Conference (2011, October 08)

There has been a long debate about appropriate BP measurement techniques for evaluating the quality of BP control, especially in kidney transplantation (KT). Thus, one aim of the present study was to ... [more ▼]

There has been a long debate about appropriate BP measurement techniques for evaluating the quality of BP control, especially in kidney transplantation (KT). Thus, one aim of the present study was to examine 3 methods of BP measurement and their reproducibility over a short period of 8 weeks. Conclusion: Home blood pressure monitoring (HBPM) and ambulatory blood pressure monitoring (ABPM) should be applied more often also in KT, among others for reasons of better reproducibility over time than office blood pressure monitoring (OBPM). [less ▲]

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See detailWhich factors might explain the divergence between clinic and out-of-clinic blood pressure (BP) in kidney transplantation (KT): the EPARA study?
Gellner, Karen; Saint-Remy, Annie ULg; BONVOISIN, Catherine ULg et al

Conference (2011, October 08)

Differences between clinic and out-of-clinic BP, defined as white coat effect (WCE), white coat hypertension (WCH) or masked hypertension (MH), can leat to misdiagnosis and -handling when decisions are ... [more ▼]

Differences between clinic and out-of-clinic BP, defined as white coat effect (WCE), white coat hypertension (WCH) or masked hypertension (MH), can leat to misdiagnosis and -handling when decisions are solely based on clinic BP measurement. One aim of the study was to examine the risk factors of WCE and MH in late KT. Conclusion:Out-of-clinic BP monitoring should be encouraged to be applied more often in high risk-populations such as KT, especially when risk factors for WCE or MH are present. [less ▲]

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See detailControl of hypertension in renal transplantation : the EPARA study
Gellner, Karen; SAINT-REMY, Annie ULg; WEEKERS, Laurent ULg et al

Conference (2011, June 26)

Blood pressure (BP) is a cardiovascular but also kidney disease risk factor, especially in high risk populations such as kidney transplantated one (KT). Therefore it must be accurately measured. The aim ... [more ▼]

Blood pressure (BP) is a cardiovascular but also kidney disease risk factor, especially in high risk populations such as kidney transplantated one (KT). Therefore it must be accurately measured. The aim of the current study was to evaluate the quality of BP control in such a population followed at the CHU Liège. [less ▲]

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See detailControl of hypertension in a kidney transplanted population : the EPARA study
Gellner, Karen; Saint-Remy, Annie ULg; Weekers, Laurent ULg et al

in Acta Clinica Belgica (2010, November 27), 66(1), 79

Detailed reference viewed: 45 (13 ULg)