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

Authors

Dóra Batta^1, , Beáta Kőrösi¹, János Nemcsik^{1, 2, *,}

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

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

^*Corresponding author. Email: janos.nemcsik@gmail.com

DOI

10.2991/artres.k.200603.002How to use a DOI?

Keywords

autonomic neuropathy; orthostatic hypotension; supine hypertension; reverse dipping; ambulatory blood pressure monitoring; central hemodynamic parameters

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.

Copyright

© 2020 Association for Research into Arterial Structure and Physiology. Publishing services by Atlantis Press International B.V.

Open Access

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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TY  - JOUR
AU  - Dóra Batta
AU  - Beáta Kőrösi
AU  - János Nemcsik
PY  - 2020
DA  - 2020/06/07
TI  - Supine Hypertension and Extreme Reverse Dipping Phenomenon Decades after Kidney Transplantation: A Case Report
JO  - Artery Research
SP  - 183
EP  - 186
VL  - 26
IS  - 3
SN  - 1876-4401
UR  - https://doi.org/10.2991/artres.k.200603.002
DO  - 10.2991/artres.k.200603.002
ID  - Batta2020
ER  -