| Progression to hypertension in non-hypertensive children following renal transplantation. | |
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MedLine Citation:
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PMID: 22287656 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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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 ≥50th but <90th percentile) and pre-hypertension (systolic and/or diastolic clinic BP 90th-95th 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 Kaplan-Meier 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 'normal' and 'optimal' range. |
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Authors:
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Manish D Sinha; Julie A Gilg; Larissa Kerecuk; Christopher J D Reid; |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-1-28 |
Journal Detail:
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Title: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association Volume: - ISSN: 1460-2385 ISO Abbreviation: - Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-1-30 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8706402 Medline TA: Nephrol Dial Transplant Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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1Department of Paediatric Nephrology, Evelina Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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