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Supine Hypertension and Extreme Reverse Dipping Phenomenon Decades after Kidney Transplantation: A Case Report

Artery Research volume 26, pages 183–186 (2020)Cite this article

Abstract

Background

Supine hypertension, a consequence of autonomic neuropathy, is a rarely recognized pathological condition. Reported diseases in the background are pure autonomic failure, multiple system atrophy, Parkinson’s disease, diabetes and different autoimmune disorders.

Methods

In our case report we present a case of supine hypertension which developed in a patient decades after kidney transplantation. The patient was followed for 25 months and we demonstrate the effect of the modification of antihypertensive medications.

Results

At the time of the diagnosis supine hypertension appeared immediately after laying down (office sitting Blood Pressure (BP): 143/101 mmHg; office supine BP: 171/113 mmHg) and on Ambulatory Blood Pressure Monitoring (ABPM) extreme reverse dipping was registered (daytime BP: 130/86 mmHg, nighttime BP: 175/114 mmHg). After the modification of the antihypertensive medications, both office supine BP (office sitting BP: 127/92 mmHg; office supine BP: 138/100 mmHg) and on ABPM nighttime BP improved markedly (daytime BP: 135/92 mmHg, nighttime BP: 134/90 mmHg).

Conclusion

In conclusions, our case report points out that autonomic neuropathy-caused supine hypertension and extreme reverse dipping can develop in chronic kidney disease, after kidney transplantation. The modification of the antihypertensive medications can slowly restore this pathological condition.

References

  1. Fanciulli A, Jordan J, Biaggioni I, Calandra-Buonaura G, Cheshire WP, Cortelli P, et al. Consensus statement on the definition of neurogenic supine hypertension in cardiovascular autonomic failure by the American Autonomic Society (AAS) and the European Federation of Autonomic Societies (EFAS): endorsed by the European Academy of Neurology (EAN) and the European Society of Hypertension (ESH). Clin Auton Res 2018;28:355–62.

    Google Scholar 

  2. Jordan J, Fanciulli A, Tank J, Calandra-Buonaura G, Cheshire WP, Cortelli P, et al. Management of supine hypertension in patients with neurogenic orthostatic hypotension: scientific statement of the American Autonomic Society, European Federation of Autonomic Societies, and the European Society of Hypertension. J Hypertens 2019;37:1541–6.

    Google Scholar 

  3. Vallelonga F, Maule S. Diagnostic and therapeutical management of supine hypertension in autonomic failure: a review of the literature. J Hypertens 2019;37:1102–11.

    Google Scholar 

  4. Batta D, Kőrösi B, Nemcsik-Bencze Z, Nemcsik J. Case report of a patient with extreme reverse dipping phenomenon decades after kidney transplantation. Artery Res 2019;25:S157.

  5. Wei W, Tölle M, Zidek W, van der Giet M. Validation of the mobil-O-Graph: 24 h-blood pressure measurement device. Blood Press Monit 2010;15:225–8.

    Google Scholar 

  6. Luzardo L, Lujambio I, Sottolano M, da Rosa A, Thijs L, Noboa O, et al. 24-h ambulatory recording of aortic pulse wave velocity and central systolic augmentation: a feasibility study. Hypertens Res 2012;35:980–7.

    Google Scholar 

  7. Wassertheurer S, Kropf J, Weber T, van der Giet M, Baulmann J, Ammer M, et al. A new oscillometric method for pulse wave analysis: comparison with a common tonometric method. J Hum Hypertens 2010;24:498–504.

    Google Scholar 

  8. Weber T, Wassertheurer S, Middlemiss J, McEniery CM, Hametner B, Mayer CC, et al. Validation of a method to estimate stroke volume from brachial-cuff derived pressure waveforms. Artery Res 2020;26:42–7.

    Google Scholar 

  9. Sanghavi S, Vassalotti JA. Practical use of home blood pressure monitoring in chronic kidney disease. Cardiorenal Med 2014;4:113–22.

    Google Scholar 

  10. Arné-Bès MC. [Neurotoxic effects of medications: an update]. Rev Med Liege 2004;59:118–23 [Article in French].

    Google Scholar 

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Authors and Affiliations

  1. Department of Family Medicine, Semmelweis University, Budapest, Hungary

    Dóra Batta, Beáta Kőrösi & János Nemcsik

  2. Department of Family Medicine, Health Service of Zugló (ZESZ), Budapest, Hungary

    János Nemcsik

Authors
  1. Dóra Batta
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  2. Beáta Kőrösi
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  3. János Nemcsik
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Corresponding author

Correspondence to János Nemcsik.

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Peer review under responsibility of the Association for Research into Arterial Structure and Physiology

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This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

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Batta, D., Kőrösi, B. & Nemcsik, J. Supine Hypertension and Extreme Reverse Dipping Phenomenon Decades after Kidney Transplantation: A Case Report. Artery Res 26, 183–186 (2020). https://doi.org/10.2991/artres.k.200603.002

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  • DOI: https://doi.org/10.2991/artres.k.200603.002

Keywords

Artery Research

ISSN: 1876-4401

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