Ambulatory blood pressure monitoring after renal transplantation in children

Morgan, Henry; Khan, Imran Ahmed; Hashmi, Aijaz; Hébert, Diane; McCrindle, Brian W.; Balfe, J. Williamson

doi:10.1007/s004670100668

Cited by 82 publications

(105 citation statements)

References 22 publications

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“…In our study, most children after renal transplantation were hypertensive and exhibited LVH. These data confirm other recent studies in children with renal transplants, describing arterial hypertension and LVH in similar percentages of the study populations [5,6,10,11].…”

Section: Discussionsupporting

confidence: 93%

Changes of blood pressure and left ventricular mass in pediatric renal transplantation

et al. 2004

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Cardiovascular events are among the most frequent causes for long-term morbidity and mortality in children after renal transplantation. The aim of this study was to analyze the effects of post-transplant changes in arterial hypertension, as assessed by 24-h ambulatory blood pressure measurement (ABPM), on myocardial architecture, as assessed by echocardiography. In a retrospective chart review analysis, 39 children were identified in whom 24-h ABPM and echocardiography had been assessed within a 3-month interval after a mean of 4 years post transplantation; 20 repeated pairs of measurements after a mean of 2 years of follow-up were available to analyze the longitudinal effects of post-transplant changes of blood pressure control on left ventricular mass index (LVMI). Arterial hypertension (59%) and left ventricular hypertrophy (50%) were highly prevalent in children after renal transplantation. Renal allograft function and number of antihypertensive medications, but not ABPM variables, were correlated with LVMI at the initial observation. However, at repeat assessment, a significant correlation between ABPM and LVMI was found. In the longitudinal assessment, left ventricular remodeling was dependent on change of dosage of cyclosporine and interval changes of blood pressure levels. Hence, control of blood pressure correlates with changes of LVMI in children with renal allografts. These results clearly underline the importance of blood pressure control for the maintenance of the myocardial architecture.

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Section: Discussionsupporting

confidence: 93%

Changes of blood pressure and left ventricular mass in pediatric renal transplantation

et al. 2004

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“…As in other pediatric studies, 18,19 we found a high prevalence of abnormal BP detected by ABPM. The important observation in this study is that daytime SBP load was superior in predicting carotid artery compliance than casual BP.…”

Section: Discussionsupporting

confidence: 64%

Abnormal Carotid Artery Structure and Function in Children and Adolescents With Successful Renal Transplantation

et al. 2004

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Background-Abnormal carotid artery compliance and increased intima-media thickness (IMT), markers of early atherosclerosis, are prevalent in adults with chronic kidney failure. However, little is known about the extent of these abnormalities in children after transplantation. Methods and Results-Thirty-one children (age, 14.5Ϯ4.1 years) with renal transplant (estimated glomerular filtration rate, 78.1Ϯ24.5 mL/min per 1.73 m 2 ; range, 44 to 128 mL/min per 1.73 m 2 ) and 33 age-and sex-matched control subjects had ultrasound of the carotid artery, echocardiography, and ambulatory blood pressure monitoring (transplant patients only). IMT was measured, and distensibility and stiffness parameter (␤) were calculated to assess carotid artery structure and function. The results were correlated with demographic, clinical, and biochemical variables. Compared with control subjects, children with transplant had higher IMT (Pϭ0.03) and ␤ (PϽ0.0001) and lower distensibility (PϽ0.001). In multiple regression analysis, increased IMT in children who had received transplants was associated with higher mean office systolic blood pressure taken within 1 year before the study (R 2 ϭ0.19, Pϭ0.024) and receipt of Ͼ1 transplant (R 2 ϭ0.16, Pϭ0.02). Worse distensibility and ␤ were significantly associated with higher daytime systolic blood pressure load calculated from ambulatory blood pressure and receipt of cadaveric kidney. When number of antihypertensives was added to the models, only higher number of blood pressure medications independently predicted abnormal distensibility (R 2 ϭ0.38, Pϭ0.002) and ␤ (R 2 ϭ0.25, Pϭ0.016). Conclusions-Carotid arteriopathy is present in children with successful renal transplant and is associated with hypertension. The results suggest that these children might be at risk for accelerated atherosclerosis and premature cardiovascular disease.

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“…to exclude hypertension) in chronic kidney disease. After renal transplantation, ABPM has proved to be more efficient than casual measurements [45] as renal transplantation is characterized by higher nocturnal BP values, a reversal of the diurnal rhythm [46] . Lack of nocturnal fall in BP and higher nocturnal BP values suggest target organ damage in primary hypertension [47] .…”

Section: Special Applications Of Abpmmentioning

confidence: 99%

Importance of Ambulatory Blood Pressure Monitoring in Adolescent Hypertension

Páll

Kiss

Katona

2011

Kidney Blood Press Res

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There has been a steady increase in the prevalence of adolescent hypertension in recent years. In order to prevent target organ damages, it is important to determine the group of hypertensive adolescents. If repeatedly elevated blood pressure values are observed, with special emphasis on white coat hypertension, which is particularly frequent at this age, ambulatory blood pressure monitoring is highly recommended before pharmacological treatment is started. In addition, performing ambulatory blood pressure monitoring is recommended with target organ damage, resistance to therapy, and suspicion of secondary hypertension. The results of the widely available, simple-to-use device are easy to reproduce.

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Ambulatory blood pressure monitoring after renal transplantation in children

Cited by 82 publications

References 22 publications

Changes of blood pressure and left ventricular mass in pediatric renal transplantation

Changes of blood pressure and left ventricular mass in pediatric renal transplantation

Abnormal Carotid Artery Structure and Function in Children and Adolescents With Successful Renal Transplantation

Importance of Ambulatory Blood Pressure Monitoring in Adolescent Hypertension

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