Ambulatory blood pressure trajectories and blood pressure variability in kidney transplant recipients: a comparative study against chronic kidney disease patients

Background Hypertension is a major cardiovascular risk factor in both kidney transplant recipients (KTRs) and patients with chronic kidney disease (CKD). Ambulatory blood pressure monitoring (ABPM) is considered the gold-standard method for hypertension management in these subjects. This is the first study evaluating the full ambulatory blood pressure (BP) profile and short-term BP variability (BPV) in KTRs versus CKD patients without kidney replacement therapy. Methods Ninety-three KTRs were matched with 93 CKD patients for age, sex, and estimated glomerular filtration rate. All participants underwent 24-hour ABPM. Mean ambulatory BP levels, BP trajectories, and BPV indices (standard deviation [SD], weighted SD, and average real variability) were compared between the two groups. Results There were no significant between-group differences in 24-hour systolic BP (SBP)/diastolic BP (DBP) (KTRs: 126.9 ± 13.1/79.1 ± 7.9 mmHg vs. CKD: 128.1 ± 11.2/77.9 ± 8.1 mmHg, p = 0.52/0.29), daytime SBP/DBP and nighttime SBP; nighttime DBP was slightly higher in KTRs (KTRs: 76.5 ± 8.8 mmHg vs. CKD: 73.8 ± 8.8 mmHg, p = 0.04). Repeated measurements analysis of variance showed a significant effect of time on both ambulatory SBP and DBP (SBP: F = [19, 3002] = 11.735, p < 0.001, partial η2 = 0.069) but not of KTR/CKD status (SBP: F = [1, 158] = 0.668, p = 0.42, partial η2 = 0.004). Ambulatory systolic/diastolic BPV indices were not different between KTRs and CKD patients, except for 24-hour DBP SD that was slightly higher in the latter group (KTRs: 10.2 ± 2.2 mmHg vs. CKD: 10.9 ± 2.6 mmHg, p = 0.04). No differences were noted in dipping pattern between the two groups. Conclusion Mean ambulatory BP levels, BP trajectories, and short-term BPV indices are not significantly different between KTRs and CKD patients, suggesting that KTRs have a similar ambulatory BP profile compared to CKD patients without kidney replacement therapy

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

A comparative study of central blood pressure, arterial stiffness and endothelial function of patients under peritoneal dialysis and hemodialysis

Hypertension, high blood pressure variability (BPV) and increased ambulatory pulse wave velocity (PWV) have been shown to be associated with increased cardiovascular events and death in hemodialysis (HD) patients. Comparative data on ambulatory blood pressure (BP) profile of peritoneal dialysis (PD) and HD are scarce, while no study has reported data on short-term BPV in PD patients or has compared the ambulatory course of central hemodynamics and PWV in these patients. This study also examined skin microcirculation using the novel method for assessment of endothelial function Laser Speckle Contrast Imaging (LSCI), as well as lung congestion assessed by lung ultrasound and chamber dimensions and systolic and diastolic performance of left and right ventricle. In the analysis of ambulatory peripheral BP profile and BPV parameters, 38 PD patients were matched with 76 HD patients (for age, gender and dialysis-vintage) and with 38 patients with chronic kidney disease (CKD) stage 2-4 (for age and gender). Patients under PD and HD underwent 48hour and CKD patients 24hour ambulatory BP monitoring with the oscillometric Mobil-O-Graph device. For the analysis of central hemodynamics, 38 patients under PD were matched with 76 patients under HD in a 1:2 ratio, as discussed above. For the study of endothelial function, 38 PD patients were matched in a 1:1 ratio with 38 HD patients and 38 controls. Finally 38 patients under PD and their matched 38 patients under HD were assessed by lung and heart ultrasound. During all periods studied, peripheral systolic BP (SBP) and diastolic BP (DBP) levels were numerically higher but not statistically different in PD than in HD patients and were significantly higher in PD or HD compared with predialysis CKD (PD:138.4±21.0; HD:133.8±15.5; CKD:125.5±13.4 mmHg, p=0.003), a difference evident also during daytime and night-time periods. Repeated-measurements analysis showed no effect of dialysis modality on ambulatory BP during all periods studied. All BPV indexes studied were similar between PD and HD patients and higher than CKD individuals (1st 24hour systolic ARV: PD:11.9±3.2; HD:11.2±3.5; CKD:9.8±2.5 mmHg, p=0.016). Over the total 48-hour period, no significant differences were observed between PD and HD patients in mean levels of central SBP, DBP, PP, AP, AIx, AIx(75) and PWV. However, PD patients had numerically higher levels than HD patients in all the above parameters during all periods studied and especially during the 1st 24-hour. Moreover, patients under PD and HD displayed different trajectories in all the above parameters over the course of the recording: in PD patients no differences were noted in central SBP (125.0±19.2 vs 126.0±17.8 mmHg, p=0.25), DBP, PP, AP, AIx(75) and PWV (9.5±2.1 vs 9.6±2.1 m/sec, p=0.27) from the 1st to the 2nd 24-hour period of the recording, while HD patients showed significant increases in all these parameters (SBP: 119.5±14.4 vs 124.6±15.0 mmHg, p<0.001; PWV: 9.1±1.8 vs 9.3±1.8 m/sec, p<0.001). Regarding the post-occlusive vascular response, the proportional increase from baseline-to-peak perfusion (PD: 149±125; HD: 133±66; controls: 187±61 %, p=0.001) and baseline-to-peak cutaneous vascular conductance (p=0.001) was significantly lower in in patients under PD and HD compared to controls. The US-B lines score did not differ between the two dialysis modalities [PD: 3.0 (2.0–6.3), HD: 4.0 (2.0–8.0) US-B lines, p=0.623]. Systolic volume (SV) and cardiac output (CO) were found to be lower in patients under PD compared to those under HD (p=0.030 and p=0.036 respectively). Finally TRV max and RVSP were found to be significantly higher in PD patients (p=0.022 and p=0.009). A significantly higher incidence of mitral valve regurgitation was also shown in patients under PD compared to those under HD (39.5% vs 10.5%, respectively, p=0.004). Average BP levels and BPV indices are similar between PD and HD patients and higher compared to CKD counterparts. Central BP, wave reflection indices and PWV during a 48hour recording are steady in PD but gradually increase in HD patients. Patients under PD and HD have similarly impaired endothelial function of skin microcirculation and similar degree of lung congestion.Η υπέρταση, η αυξημένη μεταβλητότητα της αρτηριακής πίεσης (ΑΠ), αλλά και η αυξημένη ταχύτητα σφυγμικού κύματος (Pulse Wave Velocity, PWV) υπό περιπατητικές συνθήκες σχετίζονται με αυξημένο κίνδυνο καρδιαγγειακών συμβαμάτων και θνησιμότητα σε ασθενείς υπό αιμοκάθαρση (ΑΚ). Τα υπάρχοντα δεδομένα στην περιτοναϊκή κάθαρση (ΠΚ) σχετικά με την περιπατητική ΑΠ είναι ελάχιστα, ενώ η βραχυπρόθεσμη μεταβλητότητα της περιφερικής ΑΠ καθώς και η πορεία των κεντρικών αιμοδυναμικών παραμέτρων και της PWV δεν έχει έως και σήμερα μελετηθεί στους ασθενείς αυτούς. Σκοπός της παρούσας διατριβής, εκτός από τη μελέτη των παραπάνω παραμέτρων συγκριτικά στους ασθενείς υπό ΠΚ και ΑΚ, ήταν και η αξιολόγηση της ενδοθηλιακής λειτουργίας με τη νεότερη τεχνική Laser Speckle Contrast Imaging (LSCI), η μελέτη των δεικτών ποσοτικοποίησης της υδατικής υπερφόρτωσης με υπερηχογραφικό έλεγχο πνευμόνων και τέλος η υπερηχοκαρδιογραφική μελέτη. Στην ανάλυση του προφίλ της περιπατητικής περιφερικής ΑΠ και των δεικτών μεταβλητότητας, όπως προσδιορίστηκαν από 48ωρη καταγραφή με τη συσκευή Mobil-O-Graph, 38 ασθενείς υπό ΠΚ αντιστοιχίσθηκαν με 76 ασθενείς υπό ΑΚ (για την ηλικία, το φύλο και τη διάρκεια εξωνεφρικής κάθαρσης) και με 38 ασθενείς με χρόνια νεφρική νόσο (ΧΝΝ) Σταδίου 2-4 (για την ηλικία και το φύλο). Για την ανάλυση των κεντρικών πιέσεων και των δεικτών αρτηριακής δυσκαμψίας, 38 ασθενείς υπό ΠΚ αντιστοιχίστηκαν με 76 ασθενείς υπό ΑΚ σε αναλογία 1:2, όπως περιγράφηκε προηγουμένως. Για τη μελέτη της ενδοθηλιακής λειτουργίας, 38 ασθενείς υπό ΠΚ αντιστοιχίσθηκαν σε αναλογία 1:1 με 38 ασθενείς υπό ΑΚ καθώς και με 38 μάρτυρες, ενώ για την ανάλυση των υπερηχοκαρδιογραφικών δεικτών και την αξιολόγηση της πνευμονικής συμφόρησης με υπέρηχο πνευμόνων, 38 ασθενείς υπό ΠΚ και 38 ασθενείς υπό ΑΚ αντιστοιχίστηκαν σε αναλογία 1:1. Τα επίπεδα της περιφερικής συστολικής ΑΠ (ΣΑΠ) και διαστολικής ΑΠ (ΔΑΠ) ήταν αριθμητικά αλλά όχι σημαντικά υψηλότερα στους ασθενείς υπό ΠΚ συγκριτικά με την ΑΚ, κατά τη διάρκεια όλων των περιόδων μελέτης. Η ΣΑΠ ήταν σημαντικά υψηλότερη στους ασθενείς υπό ΠΚ και ΑΚ συγκριτικά με αυτούς με ΧΝΝ στο σύνολο (ΠΚ: 138,4±21,0, ΑΚ: 133,8±15,5, ΧΝΝ: 125,5±13,4 mmHg, p=0,003, ανά ζεύγη συγκρίσεις: ΠΚ έναντι ΧΝΝ: p=0,003, ΑΚ έναντι ΧΝΝ: p=0,041) και κατά τις περιόδους ημέρας/νύχτας. Η ΔΑΠ εμφάνισε παρόμοια τάση σε όλες τις περιόδους που μελετήθηκαν με τη διαφορά να είναι σημαντική μόνο κατά τη δεύτερη νύχτα. Η ανάλυση repeated measurements ANOVA δεν ανέδειξε επίδραση της μεθόδου κάθαρσης στην περιπατητική ΑΠ. Αναφορικά με τους δείκτες μεταβλητότητας, δεν διαπιστώθηκαν σημαντικές διαφορές μεταξύ ασθενών υπό ΠΚ και ΑΚ, ωστόσο όλοι οι εξετασθέντες δείκτες ήταν αριθμητικά υψηλότεροι στις δύο ομάδες εξωνεφρικής κάθαρσης συγκριτικά με τους ασθενείς με ΧΝΝ. Η συστολική ARV ήταν σημαντικά υψηλότερη στην ΠΚ και την ΑΚ συγκριτικά με τη ΧΝΝ κατά τη διάρκεια των δύο 24ώρων (1ο 24ωρο: ΠΚ: 11,9±3,2, ΑΚ: 11,2±3,5, ΧΝΝ: 9,8±2,5 mmHg, p=0,016, 2ο 24ωρο: ΠΚ: 12,2±4,1, ΑΚ: 13,0±4,6, ΧΝΝ: 9,8±2,5, p<0,001). Δεν διαπιστώθηκαν διαφορές στον τύπο εμβύθισης (dipping) μεταξύ των 3 ομάδων σε όλες τις περιόδους της μελέτης. Μη σημαντικές διαφορές παρατηρήθηκαν μεταξύ των ασθενών υπό ΠΚ και υπό ΑΚ στα επίπεδα της κεντρικής ΣΑΠ, ΔΑΠ, ΠΠ, AP, AIx, AIx(75) και PWV κατά τη συνολική περίοδο του 48ώρου, ωστόσο στους ασθενείς υπό ΠΚ παρατηρήθηκαν αριθμητικά αλλά όχι σημαντικά υψηλότερες τιμές σε όλες τις παραπάνω παραμέτρους συγκριτικά με τους ασθενείς υπό ΑΚ σε όλες τις περιόδους της μελέτης και ειδικά κατά τη διάρκεια του 1ου 24ώρου. Επιπλέον διαπιστώθηκαν διαφορετικές τροχιές όλων των παραπάνω παραμέτρων κατά τη διάρκεια της καταγραφής. Στους ασθενείς υπό ΠΚ δεν παρατηρήθηκαν σημαντικές διαφορές από το 1ο στο 2ο 24ωρο στις τιμές της κεντρικής ΣΑΠ (125,0±19,2 έναντι 126,0±17,8 mmHg, p=0,25), ΔΑΠ, ΠΠ, AP, AIx(75) και PWV (9,5±2,1 έναντι 9,6±2,1 m/sec, p=0,27). Αντιθέτως, στους ασθενείς υπό ΑΚ διαπιστώθηκε σημαντική αύξηση σε όλες τις παραπάνω παραμέτρους (ΣΑΠ: 119,5±14,4 έναντι 124,6±15,0 mmHg, p<0,001, PWV: 9,1±1,8 έναντι 9,3±1,8 m/sec, p<0,001). Στη μελέτη της ενδοθηλιακής λειτουργίας, η ποσοστιαία μετα-αποφρακτική αύξηση της άρδευσης και της δερματικής αγγειακής αγωγιμότητας από τη βασική έως τη μέγιστη τιμή ήταν σημαντική χαμηλότερη στις δύο ομάδες ασθενών υπό ΠΚ και ΑΚ συγκριτικά με τους μάρτυρες (ποσοστιαία αύξηση άρδευσης: ΠΚ: 149±125, ΑΚ: 133±66, μάρτυρες: 187±61 %, p=0,001). Το άθροισμα των US-B lines δεν διέφερε σημαντικά μεταξύ των ομάδων ασθενών στις δύο μεθόδους εξωνεφρικής κάθαρσης [ΠΚ: 3,0 (2,0–6,3), ΑΚ: 4,0 (2,0–8,0) US-B lines, p=0,623]. Ωστόσο, ο όγκος παλμού και η καρδιακή παροχή ήταν σημαντικά χαμηλότεροι στους ασθενείς υπό ΠΚ σε σύγκριση με αυτούς υπό ΑΚ (p=0,030 και p=0,036, αντίστοιχα). Τέλος, οι δείκτες TRV max και RVSP, που αποτελούν δείκτες της συστολικής απόδοσης της RV, ήταν σημαντικά υψηλότεροι στους ασθενείς υπό ΠΚ (p=0,022 και p=0,009, αντίστοιχα). Σημαντική διαφορά διαπιστώθηκε και στον επιπολασμό της ανεπάρκειας της μιτροειδούς βαλβίδας με τα υψηλότερα ποσοστά να παρατηρούνται στους ασθενείς υπό ΠΚ (39,5% έναντι 10,5%, αντίστοιχα, p=0,004). Συμπερασματικά τα επίπεδα της περιφερικής και κεντρικής ΑΠ καθώς και οι δείκτες μεταβλητότητας, οι παράμετροι του κύματος ανάκλασης, και η PWV ήταν παρόμοιοι μεταξύ των ασθενών υπό ΠΚ και ΑΚ. Ωστόσο οι κεντρικές αιμοδυναμικές παράμετροι και η PWV παρέμειναν σταθερές στους ασθενείς υπό ΠΚ κατά τη διάρκεια της περιόδου μελέτης, ενώ στους ασθενείς υπό ΑΚ παρατηρήθηκε σταδιακή αύξησή τους. Οι ασθενείς υπό ΠΚ και ΑΚ έχουν παρόμοια και σαφώς διαταραγμένη σε σχέση με τους μάρτυρες ενδοθηλιακή λειτουργία και παρόμοιο βαθμό υπερφόρτωσης των πνευμόνων

Renin-angiotensin system blockers during the COVID-19 pandemic: an update for patients with hypertension and chronic kidney disease.

Hypertension and chronic kidney disease (CKD) are among the most common comorbidities associated with coronavirus disease 2019 (COVID-19) severity and mortality risk. Renin-angiotensin system (RAS) blockers are cornerstones in the treatment of both hypertension and proteinuric CKD. In the early months of the COVID-19 pandemic, a hypothesis emerged suggesting that the use of RAS blockers may increase susceptibility for COVID-19 infection and disease severity in these populations. This hypothesis was based on the fact that angiotensin-converting enzyme 2 (ACE2), a counter regulatory component of the RAS, acts as the receptor for severe acute respiratory syndrome coronavirus 2 cell entry. Extrapolations from preliminary animal studies led to speculation that upregulation of ACE2 by RAS blockers may increase the risk of COVID-19-related adverse outcomes. However, these hypotheses were not supported by emerging evidence from observational and randomized clinical trials in humans, suggesting no such association. Herein we describe the physiological role of ACE2 as part of the RAS, discuss its central role in COVID-19 infection and present original and updated evidence from human studies on the association between RAS blockade and COVID-19 infection or related outcomes, with a particular focus on hypertension and CKD

Sex differences in ambulatory blood pressure levels, control, and phenotypes of hypertension in kidney transplant recipients.

OBJECTIVES Ambulatory blood pressure (BP) control is worse in men compared with women with chronic kidney disease (CKD) and this may partially explain the faster CKD progression in men. This is the first study investigating possible sex differences in prevalence, control and phenotypes of hypertension in kidney transplant recipients (KTRs) with office-BP and 24-h ambulatory BP monitoring (ABPM). METHODS This cross-sectional study included 136 male and 69 female stable KTRs who underwent office-BP measurements and 24-h ABPM. Hypertension thresholds for office and ambulatory BP were defined according to the 2017 ACC/AHA and 2021 KDIGO guidelines for KTRs. RESULTS Age, time from transplantation, eGFR and history of major comorbidities did not differ between groups. Office SBP/DBP levels were insignificantly higher in men than women (130.3 ± 16.3/77.3 ± 9.4 vs. 126.4 ± 17.8/74.9 ± 11.5 mmHg; P = 0.118/0.104) but daytime SBP/DBP was significantly higher in men (128.5 ± 12.1/83.0 ± 8.2 vs. 124.6 ± 11.9/80.3 ± 9.3 mmHg; P = 0.032/P = 0.044). No significant between-group differences were detected for night-time BP. The prevalence of hypertension was similar by office-BP criteria (93.4 vs. 91.3%; P = 0.589), but higher in men than women with ABPM (100 vs. 95.7%; P = 0.014). The use of ACEIs/ARBs and CCBs was more common in men. Office-BP control was similar (43.3 vs. 44.4%, P = 0.882), but 24-h control was significantly lower in men than women (16.9 vs. 30.3%; P = 0.029). White-coat hypertension was similar (5.1 vs. 7.6%; P = 0.493), whereas masked hypertension was insignificantly more prevalent in men than women (35.3 vs. 24.2%; P = 0.113). CONCLUSION BP levels, hypertension prevalence and control are similar by office criteria but significantly different by ABPM criteria between male and female KTRs. Worse ambulatory BP control in male compared with female KTRs may interfere with renal and cardiovascular outcomes

Sex differences in ambulatory blood pressure levels, control, and phenotypes of hypertension in kidney transplant recipients

Objectives: Ambulatory blood pressure (BP) control is worse in men compared with women with chronic kidney disease (CKD) and this may partially explain the faster CKD progression in men. This is the first study investigating possible sex differences in prevalence, control and phenotypes of hypertension in kidney transplant recipients (KTRs) with office-BP and 24-h ambulatory BP monitoring (ABPM). Methods: This cross-sectional study included 136 male and 69 female stable KTRs who underwent office-BP measurements and 24-h ABPM. Hypertension thresholds for office and ambulatory BP were defined according to the 2017 ACC/AHA and 2021 KDIGO guidelines for KTRs. Results: Age, time from transplantation, eGFR and history of major comorbidities did not differ between groups. Office SBP/DBP levels were insignificantly higher in men than women (130.3 +/- 16.3/77.3 +/- 9.4 vs. 126.4 +/- 17.8/74.9 +/- 11.5 mmHg; P = 0.118/0.104) but daytime SBP/DBP was significantly higher in men (128.5 +/- 12.1/83.0 +/- 8.2 vs. 124.6 +/- 11.9/80.3 +/- 9.3 mmHg; P = 0.032/P = 0.044). No significant between-group differences were detected for night-time BP. The prevalence of hypertension was similar by office-BP criteria (93.4 vs. 91.3%; P = 0.589), but higher in men than women with ABPM (100 vs. 95.7%; P = 0.014). The use of ACEIs/ARBs and CCBs was more common in men. Office-BP control was similar (43.3 vs. 44.4%, P = 0.882), but 24-h control was significantly lower in men than women (16.9 vs. 30.3%; P = 0.029). White-coat hypertension was similar (5.1 vs. 7.6%; P = 0.493), whereas masked hypertension was insignificantly more prevalent in men than women (35.3 vs. 24.2%; P = 0.113). Conclusion: BP levels, hypertension prevalence and control are similar by office criteria but significantly different by ABPM criteria between male and female KTRs. Worse ambulatory BP control in male compared with female KTRs may interfere with renal and cardiovascular outcomes