IMPACT OF AMBULATORY BLOOD PRESSURE MONITORING ON LIVING KIDNEY DONATION

动态血压监测对活体肾捐献的影响

• 批准号: 7718117
• 负责人: Elizabeth Ommen
• 金额: $ 3.02万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-03-01 至 2009-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7718117
• 关键词: Affect; Ambulatory Blood Pressure Monitoring; Back; Blood Pressure; Characteristics; Clinic; Computer Retrieval of Information on Scientific Projects Database; Diabetes Mellitus; Diagnosis; Frequencies; Funding; Grant; High Blood Pressure; Hour; Individual; Institution; Kidney; Kidney Diseases; Kidney Transplantation; Life; Living Donors; Measures; Monitor; Operative Surgical Procedures; Patients; Pattern; Persons; Reading; Research; Research Personnel; Resources; Risk; Severities; Source; Time; Transplant Recipients; Transplantation; United States; United States National Institutes of Health; white coat hypertension

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Roughly one-third of kidney transplants performed in the United States use kidneys from living donors. High blood pressure in a potential donor is generally considered to be a contraindication to living kidney donation because there is concern, though never proven, that this may increase the risk of kidney disease and worsened high blood pressure in the donor. Ambulatory blood pressure monitoring (ABPM) measures blood pressure multiple times over 24 hours while a patient wears a small, portable monitor and performs his or her usual activities. ABPM has been shown to be better at measuring a person's true blood pressure. We propose comparing clinic blood pressure and ABPM to determine the frequency with which the diagnosis of high blood pressure or normal blood pressure is changed by the ABPM recordings. Identifying cases of "white coat hypertension"-blood pressure that is high in the doctor's office but otherwise normal-- can expand the potential living donor pool, while identifying true cases of high blood pressure that were missed by a single clinic reading can protect potential donors from proceeding with a potentially harmful surgery. Though there are several studies evaluating living kidney donors after donation, no study has followed donors from the time prior to transplant. The studies that look back in time provide limited information because a high percentage of former donors within any group are not included and because there is no way to compare individual characteristics before donation with how well patients do. We propose examining ABPM recordings and markers of kidney disease at 6 month intervals following transplant to monitor changes in these values. Further, we will determine if patterns of ABPM recordings affect these changes. In most people, nighttime blood pressure is 10-20 percent lower than daytime blood pressure. This phenomenon is called "dipping" and the absence of dipping is associated with worsened kidney disease in patients with high blood pressure and diabetes. We propose obtaining ABPM recordings in transplant recipients both before and after transplant to determine whether the dipping status of the living donor has any effect on the dipping status of the transplant recipient or on the severity of high blood pressure in the recipient after transplant.

该副本是利用众多研究子项目之一 由NIH/NCRR资助的中心赠款提供的资源。子弹和 调查员（PI）可能已经从其他NIH来源获得了主要资金， 因此可以在其他清晰的条目中代表。列出的机构是 对于中心，这不一定是调查员的机构。 在美国进行的大约三分之一的肾脏移植物使用来自活捐赠者的肾脏。 通常认为潜在供体的高血压被认为是捐赠肾脏捐赠的禁忌症，因为人们担心，尽管从未证明，但这可能会增加肾脏疾病的风险，并使供体的高血压恶化。卧床血压监测（ABPM）在24小时内多次测量血压，而患者佩戴了小型便携式监测器并进行他或她通常的活动。 ABPM已被证明在测量一个人的真实血压方面更好。我们建议比较临床血压和ABPM，以确定ABPM记录改变高血压或正常血压诊断的频率。识别医生办公室中较高但正常的“白涂层高血压”的病例可以扩大潜在的活体供体库，同时识别单个诊所阅读所遗漏的真实高血压病例可以保护潜在的供体免受潜在有害手术的行动。 尽管有几项研究在捐赠后评估活着的肾脏供体的研究，但从移植前的时间开始，尚无研究。回顾过去的研究提供了有限的信息，因为不包括任何小组中的前捐助者，并且没有办法在捐赠之前与患者的表现进行比较。 我们建议在移植后以6个月的间隔检查肾脏疾病的ABPM记录和标记，以监视这些值的变化。此外，我们将确定ABPM记录的模式是否影响这些变化。 在大多数人中，夜间血压比白天血压低10-20％。这种现象称为“浸入”，缺乏浸入与高血压和糖尿病患者的肾脏疾病恶化有关。我们建议在移植前后，在移植受者中获得ABPM记录，以确定活体供体的浸入状态是否会影响移植受者的浸入状态或移植后受体中高血压的严重程度。