Full text
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| Author(s): |
Fabiana Agena
Total Authors: 1
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| Document type: | Master's Dissertation |
| Press: | São Paulo. |
| Institution: | Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD) |
| Defense date: | 2011-01-17 |
| Examining board members: |
Elias David Neto;
Maria Cristina Ribeiro de Castro;
Angela Maria Geraldo Pierin
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| Advisor: | Elias David Neto |
| Abstract | |
Hypertension is highly prevalent among kidney transplantation recipients and considered an important cardiovascular risk factor influencing patient survival and kidney graft survival. The aim of this study were to compare the blood pressure (BP) control in kidney transplant patients through the use of home blood pressure monitoring is more comparable with the results of ambulatory blood pressure monitoring compared to the measurement of office blood pressure. From March 2008 to April 2009 prospectively we were evaluated 183 kidney transplant recipients with time after transplantation 1 - 10 years. Patients underwent three methods for measuring blood pressure: office blood pressure measurement (OM), home blood pressure monitoring (HBPM) and ambulatory blood pressure monitoring (ABPM). We evaluated 183 patients, among them 94 men (54%) and 89 women (46%). The average age was 50 ± 11 years. The average time of transplant was 57 ± 32 months. Ninety-nine patients received grafts from deceased donors (54%) and 84 were recipients of living donors (46%). When assessed using OM, 56.3% presented with uncontrolled and 43.7% with adequate control of BP with an average of 138.9 / 82.3 ± 17.8 / 12.1 mmHg. However, when measured by HBPM, 55.2% of subjects were controlled and 44.8% presented with uncontrolled BP with an average of 131.1 / 78.5 ± 17.4 / 8.9 mmHg. Using the ABPM we observed that 63.9% of subjects had was controlled and 36.1% of patients presented uncontrolled BP with an average 128.8 / 80.5 ± 12.5 / 8.1.mmHg We found that the two methods (OM and HBPM) has a significant agreement, but the HBPM has a higher agreement than OM, confirmed by Fisher exact test, with descriptive value of 0.026.We found that there is no symmetry in the data for both methods with McNemar test. Person´s correlation for the ABPM with the other two methods were 0.494 for office measurement and 0.768 for HBPM, best value of HBPM with ABPM. Comparing the errors of the two methods by paired t-test, we obtained the descriptive level of 0.837, we conclude that the average error is equal to OM of HBPM. Looking at the ROC curve for BP measurements in each method, we observed that BP in practice presents lower than those obtained by HBPM in relation to ABPM. We conclude that the results obtained with HBPM were closer to the ABPM results than those obtained with blood pressure obtained at OM (AU) | |
| FAPESP's process: | 07/06403-9 - Evaluation of the blood pressure in kidney transplantation recipients by four methods of monitoring |
| Grantee: | Fabiana Agena |
| Support Opportunities: | Scholarships in Brazil - Master |