Relation between blood pressure and dose, plasma concentration of Tacrolimus in patients with renal transplantation

Abstracts

ison with the value before coronary angiography, urinary α1-MG, TRF and mALB or serum cystatin C and hsCRP significantly increased at day 1 after angiography (P < 0.01). In comparison to the day 1 levels taken after angiography, urinary α1-MG, TRF, mALB, and serum cystatin C significantly decreased at day 2 after angiography (P < 0.01). 2) In comparison with the value before coronary angiography in atorvastatintreated group, urinary α1-MG, TRF and mALB or serum cystatin C levels at day 1 after angiography had no significant change compared to baseline (P > 0.05), the same results in day 2 too. 3) Compared to the control group, the values of urinary α1-MG, TRF and mALB or Cys C and hsCRP significantly decreased at day 1 after angiography in the atorvastatin-treated group (P < 0.01). Urinary α1-MG, cystatin C and hsCRP significantly decreased at day 2 (P < 0.01) too, but TRF and mALB had no significant change at day 1 or day 2 after angiography in the two groups (P > 0.05). Conclusion: Pretreatment with atorvastatin 20 mg/ qn for 2 to 3 days significantly reduced procedural inflammatory reactions, light increasing in urinary protein and the effect of degrading GFR in coronary angiography patients. doi:10.1016/j.ijcard.2009.09.318

KI000733 Relation between heart rate variability and urinary albumin creatinine ratio in essential hypertension patients QIAN ZHANG, N.L. SUN Peking University People's Hospital, China Objective: To explore the relationship between urinary albumin creatinine ratio (UACR) and heart rate variability (HRV) in essential hypertensive patients. Design and methods: A total of 360 untreated patients, patients divided into essential hypertension (EH) group (n = 181), and normal control group (n = 179) were enrolled and divided into type 2 diabetic (T2DM) and non-type 2 diabetic (NT2DM) subgroups. Holter recording HRV and urinary albumin creatinine ratio were observed before treatment in both groups. Results: HRV indexes, such as SDNN (standard deviation of all normal to normal R–R intervals) and HRVTI (HRV indexes of time domain) and frequency domain analysis indexes, namely LF, HF, LF/HF, and VLF were decreased by turns in (EH + T2DM) group (n = 80), (EH) group (n = 101), (T2DM) group (n = 111) and normal group (n = 68) (P < 0. 05). Urinary albumin creatinine ratio (UACR) was decreased by turns in (EH + T2DM) group (n = 80), (T2DM) group (n = 111), (EH) group (n = 101) and normal group (n = 68) (P < 0. 05). HRVTI, LF/HF and VLF were associated with UACR in different stages (P < 0.05, F = 5.756). Conclusions: HRV parameters all decreased by turns in (EH + T2DM) group, (EH) group, (T2DM) group and normal group. The same change also was found in UACR. HRVTI, LF/HF and VLF are more highly correlated with the UACR. doi:10.1016/j.ijcard.2009.09.320

KI000774 Relation between blood pressure and dose, plasma concentration of Tacrolimus in patients with renal transplantation H. YUANa, L.Y. XIb, L.J. ZHUc, Z.J. HUANGa, G.P. YANGb Department of Cardiology, The Third Xiangya Hospital of Central South University, China b School of Pharmaceutical Sciences, Central South University, China c Organ Transplant Center, The Third Xiangya Hospital of Central South University, China a

Objectives: To investigate the incidence of hypertension in Chinese renal transplant patients with Tacrolimus, and correlate blood pressure

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with the dosages given, plasma concentration and concentration/dose ratio of Tacrolimus. Methods: Screening 200 patients randomly from renal transplant patients receiving immunosuppressive therapy with Tacrolimus, mycophenolate and prednisone regimen after the operation, and measuring their blood pressure. Then, 53 patients with hypertension and 53 normotensive patients were drawn randomly from the 200 patients. After ongoing treatment with Tacrolimus at a stable dose for at least 1 week, the daily dose of Tacrolimus was recorded and blood for Tacrolimus concentration was drawn 12 h following the dose. The Tacrolimus trough level was assayed by Microparticle Enzyme Immunoassay (MEIA), and the date was analyzed by t-test analysis. Results: 52.0% (104 in 200 cases) of Chinese renal transplant patients with Tacrolimus got hypertension. The daily doses of Tacrolimus in the hypertension group and normotensive group were (3.11 ± 1.49) mg d− 1 and (2.42 ± 1.07) mg d− 1 respectively (p < 0.05). It was much higher in the hypertension group compared with the normotensive patients. The plasma Tacrolimus concentrations of the hypertension group and normotensive group were (7.76 ± 3.86) ng ml− 1 and (7.56 ± 2.67) ng ml− 1, there was no significant difference between the two groups (p > 0.05). And the concentration/dose ratios of Tacrolimus were (2.94 ± 1.57) ng ml− 1/ (mg d− 1) and (3.95 ± 3.02) ng ml− 1/(mg d− 1) respectively (p < 0.05), it was significantly lower in the hypertension group than in the normotensive group. Conclusions: The blood pressure of renal transplant patients was closely correlated with dosage and concentration/dose ratio of Tacrolimus. The patients with higher dose of Tacrolimus were more likely to get hypertension. In order to reach effective blood Tacrolimus level, patients with hypertension may require higher dose of Tacrolimus than the normotensive patients. doi:10.1016/j.ijcard.2009.09.321

KI000863 The profile of hypertension in autosomal dominant polycystic kidney disease ALMA IDRIZI, MYFTAR BARBULLUSHI, ALKETA KOROSHI, ELIZAMA PETRELA, SULEJMAN KODRA, VALBONA BAJRAMI, NESTOR THERESKA UHC Mother Teresa, Albania The aim of this study was to evaluate the frequency of hypertension in autosomal dominant polycystic kidney disease (ADPKD) patients and its correlation with renal function, renal structure and its influence in left ventricular wall. Two hundred patients were included in the study. The patients were divided in two groups: first group of 92 patients with normal renal function, and second group of 108 patients with chronic renal failure. All patients performed an abdominal ultrasound and a Mmode echocardiography. Hypertension was observed in 140 ADPKD patients (70%): 56 of the first group (61%) and 84 of the second group (79%). Subjects who developed hypertension before age 35 had worse renal survival than those who remained normotensive after age 35 (50 years vs. 62 years; p < 0.0001; risk ratio = 4.3). Hypertensive patients had significantly higher serum creatinine concentration than those without hypertension (p < 0.001). Left ventricular hypertrophy was present in 56 patients with hypertension (40%) and in 9 normotensive patients (16%) (p <0.005). Patients with LVH had a worse renal survival than those without LVH (p < 0.001). Also, we have studied the role of renal cystic enlargement in initiating hypertension in ADPKD and on renal function. We conclude that hypertension is a common complication in our ADPKD patients, considering as an important factor of cardiac hypertrophy. LVH could be considered a more valid measure of blood pressure control than office blood pressure measurements. The blood pressure correlates with kidney size in ADPKD patients. With more increased kidney volume, the highest blood pressure is observed. These findings suggest that hypertension is a serious complication in ADPKD