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Sex and age as determinants for high blood pressure in pediatric renal transplant recipients: a longitudinal analysis of the CERTAIN Registry
RI. Sugianto, BMW. Schmidt, N. Memaran, A. Duzova, R. Topaloglu, T. Seeman, S. König, L. Dello Strologo, L. Murer, ZB. Özçakar, M. Bald, M. Shenoy, A. Buescher, PF. Hoyer, M. Pohl, H. Billing, J. Oh, H. Staude, M. Pohl, G. Genc, G. Klaus, C....
Language English Country Germany
Document type Journal Article, Research Support, Non-U.S. Gov't
NLK
ProQuest Central
from 1996-08-01 to 1 year ago
Medline Complete (EBSCOhost)
from 1996-08-01 to 1 year ago
Nursing & Allied Health Database (ProQuest)
from 1996-08-01 to 1 year ago
Health & Medicine (ProQuest)
from 1996-08-01 to 1 year ago
Family Health Database (ProQuest)
from 1996-08-01 to 1 year ago
- MeSH
- Time Factors MeSH
- Cyclosporine administration & dosage adverse effects pharmacokinetics MeSH
- Child MeSH
- Hypertension diagnosis epidemiology etiology MeSH
- Immunosuppressive Agents administration & dosage adverse effects pharmacokinetics MeSH
- Humans MeSH
- Longitudinal Studies MeSH
- Blood Pressure Determination statistics & numerical data MeSH
- Adolescent MeSH
- Follow-Up Studies MeSH
- Child, Preschool MeSH
- Prevalence MeSH
- Transplant Recipients statistics & numerical data MeSH
- Registries statistics & numerical data MeSH
- Graft Rejection immunology prevention & control MeSH
- Retrospective Studies MeSH
- Sex Factors MeSH
- Tacrolimus administration & dosage adverse effects pharmacokinetics MeSH
- Kidney Transplantation adverse effects MeSH
- Age Factors MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Child, Preschool MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Europe MeSH
BACKGROUND: High prevalence of arterial hypertension is known in pediatric renal transplant patients, but how blood pressure (BP) distribution and control differ between age groups and whether sex and age interact and potentially impact BP after transplantation have not been investigated. METHODS: This retrospective analysis included 336 pediatric renal transplant recipients (62% males) from the Cooperative European Pediatric Renal Transplant Initiative Registry (CERTAIN) with complete BP measurement at discharge and 1, 2 and 3 years post-transplant. RESULTS: At discharge and 3 years post-transplant, arterial hypertension was highly prevalent (84% and 77%); antihypertensive drugs were used in 73% and 68% of the patients. 27% suffered from uncontrolled and 9% from untreated hypertension at 3 years post-transplant. Children transplanted at age < 5 years showed sustained high systolic BP z-score and received consistently less antihypertensive treatment over time. Younger age, shorter time since transplantation, male sex, higher body mass index (BMI), high cyclosporine A (CSA) trough levels, and a primary renal disease other than congenital anomalies of the kidney and urinary tract (CAKUT) were significantly associated with higher systolic BP z-score. Sex-stratified analysis revealed a significant association between high CSA and higher systolic BP in older girls that likely had started puberty already. An association between BP and estimated glomerular filtration rate was not detected. CONCLUSIONS: BP control during the first 3 years was poor in this large European cohort. The description of age- and sex-specific risk profiles identified certain recipient groups that may benefit from more frequent BP monitoring (i.e. young children) or different choices of immunosuppression (i.e. older girls).
Center for Children and Adolescent Pediatric Clinic 2 University of Duisburg Essen Essen Germany
Department of General Pediatrics University Hospital Muenster Muenster Germany
Department of General Pediatrics University of Tuebingen Tuebingen Germany
Department of Nephrology Hannover Medical School Hannover Germany
Department of Pediatric Nephrology Izmir Tepecik Teaching and Research Hospital Izmir Turkey
Department of Pediatrics 1 University Children's Hospital Heidelberg Heidelberg Germany
Department of Pediatrics 2nd Faculty of Medicine Charles University Prague Czech Republic
Division of Pediatric Nephrology Faculty of Medicine Ankara University Ankara Turkey
Division of Pediatric Nephrology Faculty of Medicine Hacettepe University Ankara Turkey
Division of Pediatric Nephrology Faculty of Medicine Ondokuz Mayis University Samsun Turkey
KfH Kidney Centre for Children and Adolescents St Georg Hospital Leipzig Germany
KfH Kidney Centre for Children and Adolescents University Hospital Giessen Marburg Marburg Germany
Olga Children's Hospital Clinic of Stuttgart Stuttgart Germany
Pediatric Nephrology Dialysis and Transplant Unit Hospital University Padua Padua Italy
Renal Transplant Clinic Bambino Gesu Children's Hospital IRCCS Rome Italy
Royal Manchester Hospital Manchester UK
References provided by Crossref.org
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- $a BACKGROUND: High prevalence of arterial hypertension is known in pediatric renal transplant patients, but how blood pressure (BP) distribution and control differ between age groups and whether sex and age interact and potentially impact BP after transplantation have not been investigated. METHODS: This retrospective analysis included 336 pediatric renal transplant recipients (62% males) from the Cooperative European Pediatric Renal Transplant Initiative Registry (CERTAIN) with complete BP measurement at discharge and 1, 2 and 3 years post-transplant. RESULTS: At discharge and 3 years post-transplant, arterial hypertension was highly prevalent (84% and 77%); antihypertensive drugs were used in 73% and 68% of the patients. 27% suffered from uncontrolled and 9% from untreated hypertension at 3 years post-transplant. Children transplanted at age < 5 years showed sustained high systolic BP z-score and received consistently less antihypertensive treatment over time. Younger age, shorter time since transplantation, male sex, higher body mass index (BMI), high cyclosporine A (CSA) trough levels, and a primary renal disease other than congenital anomalies of the kidney and urinary tract (CAKUT) were significantly associated with higher systolic BP z-score. Sex-stratified analysis revealed a significant association between high CSA and higher systolic BP in older girls that likely had started puberty already. An association between BP and estimated glomerular filtration rate was not detected. CONCLUSIONS: BP control during the first 3 years was poor in this large European cohort. The description of age- and sex-specific risk profiles identified certain recipient groups that may benefit from more frequent BP monitoring (i.e. young children) or different choices of immunosuppression (i.e. older girls).
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