Progression to hypertension in non-hypertensive children following renal transplantation
Background: The aim of this study was to evaluate in non-hypertensive children following renal transplantation (TX) the rates and determinants of transition to hypertension. Methods: Retrospective case note review of all current paediatric kidney transplant patients in the UK. At baseline (6 months following TX), all included subjects were non-hypertensive with systolic and/or diastolic clinic blood pressure (BP) 95th percentile while on no anti-hypertensive therapy. We assessed progression from optimal (systolic and/or diastolic clinic BP 50th percentile), normal (systolic and/or diastolic cl... Mehr ...
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Dokumenttyp: | Artikel |
Erscheinungsdatum: | 2012 |
Reihe/Periodikum: | Sinha , M , Gilg , J A , Kerecuk , L , Reid , C 2012 , ' Progression to hypertension in non-hypertensive children following renal transplantation ' , Nephrology, Dialysis, Transplantation , vol. 27 , no. 7 , pp. 2990-2996 . https://doi.org/10.1093/ndt/gfr784 |
Schlagwörter: | blood pressure / children / normotension / pre-hypertension / BLOOD-PRESSURE / CYCLOSPORINE MICROEMULSION / CARDIOVASCULAR-DISEASE / KIDNEY-DISEASE / DUTCH COHORT / PARTICIPANTS / TACROLIMUS / ADULTS / RISK / CHILDHOOD |
Sprache: | Englisch |
Permalink: | https://search.fid-benelux.de/Record/base-26634888 |
Datenquelle: | BASE; Originalkatalog |
Powered By: | BASE |
Link(s) : | https://kclpure.kcl.ac.uk/portal/en/publications/20006a5a-4e65-4bbc-a032-21d2f2fde7d7 |
Background: The aim of this study was to evaluate in non-hypertensive children following renal transplantation (TX) the rates and determinants of transition to hypertension. Methods: Retrospective case note review of all current paediatric kidney transplant patients in the UK. At baseline (6 months following TX), all included subjects were non-hypertensive with systolic and/or diastolic clinic blood pressure (BP) 95th percentile while on no anti-hypertensive therapy. We assessed progression from optimal (systolic and/or diastolic clinic BP 50th percentile), normal (systolic and/or diastolic clinic BP epsilon 50th but 90th percentile) and pre-hypertension (systolic and/or diastolic clinic BP 90th95th percentile) to hypertension (systolic and/or diastolic clinic BP 95th percentile). If systolic and diastolic BP levels belonged to different categories, the higher of the two levels were used for categorization. Results: At baseline, 146 of 524 (27.9%) children (106 male) median [inter-quartile range (IQR)] age 7.8 years (4.8, 11.8) were non-hypertensive and not on any anti-hypertensive therapy; there were 34 patients (23.2%) with optimal BP, 90 (61.6%) with normal BP and 22 (15.1%) with pre-hypertension. They were followed up for a median of 2.0 (1.0, 4.0) years post-TX. At the end of follow-up, BP was optimal in 37 patients (25.3%), normal in 35 (24.0%), high normal in 2 (1.4%) and 72 (49.3%) had progressed to hypertension. The KaplanMeier estimated time at which 50% of patients developed hypertension was 2.0 years for the pre-hypertension and 3.0 years in the normal BP group as opposed to 40% risk at 7-year post-TX in the optimal group (P 0.001 between the three groups). The differences between BP groups remained significant after adjustment for all risk factors on multivariate analysis. Conclusions: Just over 49% of our initially non-hypertensive patients progressed to hypertension following TX. BP needs careful monitoring post-TX and ideally should be maintained in the onormal' and ooptimal' range.