The impact of kidney transplantation on 24–hour ambulatory blood pressure in end–stage renal disease patients

• After kidney transplantation, overall status of hypertension shows improvement.
• Dipping status in 24–hour blood pressure monitoring does not show improvement.
• Improvement of dipping status is associated with favorable allograft function.

In this study, we prospectively investigated the impact of kidney transplantation (KT) on the status of hypertension, including circadian rhythm in end–stage renal disease (ESRD) patients. We performed 24–hour ambulatory blood pressure (BP) monitoring and office BP measurement in 48 patients before and 1 year after KT. According to the nocturnal reduction in systolic BP (ΔSBP), the patients were divided into dippers, non–dippers, and reverse dippers. After KT, the mean BP value in office BP and 24–hour ambulatory BP monitoring did not change, but the proportion of patients taking anti–hypertensive drugs and the pill number significantly decreased. In contrast, the mean ΔSBP significantly decreased, and the proportion of non–dippers and reverse dippers did not decrease. Decrease in ΔSBP after KT was associated with inferior allograft function during follow–up. Our study suggests that KT improved the overall BP level, but it did not affect abnormal circadian rhythm in ESRD patients.