Ambulatory blood pressure monitoring in children after renal transplantation

Seeman, Tomáš; Dušek, Jiří; Vondrák, Karel; Šimková, Eva; Kreisinger, J; Feber, Janusz; Janda, Jan

doi:10.1016/j.transproceed.2004.04.081

Cited by 21 publications

(17 citation statements)

References 11 publications

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“…Of the nondippers, three (10%) actually had a mean night BP higher than the day mean. As expected, these abnormalities extend into the dialysis and transplant populations as well [39][40][41]. Wuhl et al have also shown that shorter ultradian (<24 h) variation in BP is abnormal in children with chronic kidney disease along with this abnormal 24-h pattern [42].…”

Section: Masked Hypertensionmentioning

confidence: 58%

Ambulatory blood pressure monitoring: a versatile tool for evaluating and managing hypertension in children

Acosta¹,

McNiece

2008

Pediatr Nephrol

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In recent years, pediatric practitioners have increasingly used ambulatory blood pressure (ABP) monitoring for evaluating blood pressure (BP) abnormalities in children. ABP monitoring in adults is superior to casual BP measurements for predicting cardiovascular morbidity and mortality, and whereas the association with target-organ damage in children is not as definitive, early evidence does seem to parallel the adult data. In addition to confirming hypertension at diagnosis, ABP monitoring may be useful for identifying isolated nocturnal hypertension, characterizing BP patterns, and assessing response to therapeutic interventions. This article reviews current evidence supporting the use of ABP monitoring in children and discusses limitations in our understanding of this technology, specifically focusing on indications for its use and interpretation of the large quantity of data obtained by ABP monitoring.

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Section: Masked Hypertensionmentioning

confidence: 58%

Ambulatory blood pressure monitoring: a versatile tool for evaluating and managing hypertension in children

Acosta¹,

McNiece

2008

Pediatr Nephrol

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“…97 The prevalence of hypertension is even higher with ABPM, approaching 70%-80%. Studies show the prevalence of masked hypertension (normal office BP and elevated ABPM) was 50% greater than that identified using casual BP [98][99][100][101] and an increased prevalence of nondippers among children with kidney transplants. 101,102 A study by Polónia et al 103 concurs with other studies showing significant rates of nocturnal hypertension in pediatric transplant recipients and that a significant proportion of patients thought to be adequately controlled by medications still had masked hypertension.…”

Section: Hypertension In the Pediatric Transplant Recipient Or Recipimentioning

confidence: 95%

Assessment and Management of Hypertension in Transplant Patients

Weir

Burgess

Cooper

et al. 2015

Journal of the American Society of Nephrology

149

111

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Hypertension in renal transplant recipients is common and ranges from 50% to 80% in adult recipients and from 47% to 82% in pediatric recipients. Cardiovascular morbidity and mortality and shortened allograft survival are important consequences of inadequate control of hypertension. In this review, we examine the epidemiology, pathophysiology, and management considerations of post-transplant hypertension. Donor and recipient factors, acute and chronic allograft injury, and immunosuppressive medications may each explain some of the pathophysiology of post-transplant hypertension. As observed in other patient cohorts, renal artery stenosis and adrenal causes of hypertension may be important contributing factors. Notably, BP treatment goals for renal transplant recipients remain an enigma because there are no adequate randomized controlled trials to support a benefit from targeting lower BP levels on graft and patient survival. The potential for drugdrug interactions and altered pharmacokinetics and pharmacodynamics of the different antihypertensive medications need to be carefully considered. To date, no specific antihypertensive medications have been shown to be more effective than others at improving either patient or graft survival. Identifying the underlying pathophysiology and subsequent individualization of treatment goals are important for improving long-term patient and graft outcomes in these patients.

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“…The extent of scarring from chronic pyelonephritis or vesicoureteral reflux was strongly correlated with ABPM in a study of 61 children [115] but did not correlate better than casual office blood pressure in children with isolated microhematuria [116]. In chronic, stable children after renal transplantation, ABPM was better at detecting high rates of hypertension than casual office blood pressure, [117,118] but did not correlate well with the left ventricular mass index in these children, suggesting that the cardiac hypertrophy seen may have a mechanism beyond hypertension [118]. In children after hemolytic uremic syndrome, daytime ABPM was not different in those children with and without renal insufficiency.…”

Section: Additional Uses Of Abpmmentioning

confidence: 96%

Utility of ambulatory blood pressure monitoring in children and adolescents

Graves

Althaf

2006

Pediatr Nephrol

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Diagnosis of hypertension is critically dependent on accurate blood pressure measurement. "Accurate" refers to carefully following the guidelines for blood pressure measurement laid out for children and adults to minimize observer and subject errors that commonly occur in clinical blood pressure measurement. Accurate blood pressure measurement is more important in children and adolescents as the misdiagnosis of hypertension may have a life-long adverse impact on insurability and employment. Automated blood pressure measurement offers multiple advantages in achieving high-quality blood pressure determinations by reducing observer errors. The most commonly used form of automated blood pressure measurement is 24-h ambulatory blood pressure measurement (ABPM). Information on ABPM in children has grown exponentially over the last decade. Normative data exists for diagnosis of hypertension in children using ABPM including a novel method for determining normal values with the LMS method. There is further information about the utility of different determinants of 24-h blood pressure such as dipping status, morning surge and blood pressure load. ABPM has been able to detect significant differences in blood pressure in many disease states in children including chronic renal failure, polycystic kidney disease, solitary functioning kidney, and after renal transplantation. Increasingly nonambulatory automated blood pressure determinations have been used in management of hypertension in children. Although nonambulatory automated readings lack information about nocturnal blood pressure or blood pressure during daily activity, studies have suggested that home automated blood pressure measurements are a helpful adjunct to the usual office blood pressure reading.

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Ambulatory blood pressure monitoring in children after renal transplantation

Cited by 21 publications

References 11 publications

Ambulatory blood pressure monitoring: a versatile tool for evaluating and managing hypertension in children

Ambulatory blood pressure monitoring: a versatile tool for evaluating and managing hypertension in children

Assessment and Management of Hypertension in Transplant Patients

Utility of ambulatory blood pressure monitoring in children and adolescents

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