Improved control of hypertension in children after renal transplantation: results of a two-yr interventional trial
Language English Country Denmark Media print
Document type Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't
PubMed
17631016
DOI
10.1111/j.1399-3046.2006.00661.x
PII: PTR661
Knihovny.cz E-resources
- MeSH
- Blood Pressure Monitoring, Ambulatory MeSH
- Antihypertensive Agents therapeutic use MeSH
- Time Factors MeSH
- Kidney Failure, Chronic surgery MeSH
- Circadian Rhythm MeSH
- Child MeSH
- Hypertension drug therapy etiology physiopathology MeSH
- Blood Pressure drug effects physiology MeSH
- Humans MeSH
- Adolescent MeSH
- Follow-Up Studies MeSH
- Child, Preschool MeSH
- Prospective Studies MeSH
- Cross-Sectional Studies MeSH
- Kidney Transplantation adverse effects MeSH
- Treatment Outcome MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Adolescent MeSH
- Child, Preschool MeSH
- Publication type
- Journal Article MeSH
- Clinical Trial MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Antihypertensive Agents MeSH
Hypertension is a frequent complication in children after renal transplantation and the control of post-transplant hypertension is unsatisfactorily low. The aim of this prospective interventional study was to improve the control of hypertension in children after renal transplantation. Thirty-six children fulfilled the inclusion criteria (> or =6 months after transplantation and no acute rejection in the last three months). BP was measured using ABPM. Hypertension was defined as mean ambulatory BP > or =95th-centile for healthy children and/or using antihypertensive drugs. The study intervention consisted of using intensified antihypertensive drug therapy - in children with uncontrolled hypertension (i.e., mean ambulatory BP was > or =95th centile in treated children), antihypertensive therapy was intensified by adding new antihypertensive drugs to reach goal BP <95th centile. ABPM was repeated after 12 and 24 months. Daytime BP did not change significantly after 12 or 24 months. Night-time BP decreased from 1.57 +/- 1.33 to 0.88 +/- 0.84 SDS for systolic and from 1.10 +/- 1.51 to 0.35 +/- 1.18 SDS for diastolic BP after 24 months (p < 0.05). The number of antihypertensive drugs increased from 2.1 +/- 0.9 to 2.7 +/- 0.8 drugs per patient (p < 0.05), this was especially seen with the use of ACE-inhibitors (increase from 19% to 40% of children, p < 0.05). In conclusion, this interventional trial demonstrated that, in children after renal transplantation, the control of hypertension, especially at night-time, can be improved by increasing the number of antihypertensive drugs, especially ACE-inhibitors.
References provided by Crossref.org
Isolated nocturnal hypertension is associated with increased left ventricular mass index in children
Should ACE inhibitors or calcium channel blockers be used for post-transplant hypertension?
Management of proteinuria in the transplanted patient
Ambulatory blood pressure monitoring in pediatric renal transplantation
Profiling proteinuria in children after renal transplantation
Hypertension after renal transplantation
