Short-term pediatric renal transplant survival: blood pressure and allograft function.
Hypertension is prevalent after renal transplantation (Tx) and associated with graft failure in children and adults. However, the effect of blood pressure (BP) on short-term renal allograft function is uncertain. We assessed the associations among BP pretransplant, and 3 months and 1 yr post-transplant, and 1-yr post-transplant measured glomerular filtration rate (mGFR) in 61 children with a functioning graft. The GFR was determined using a single intravenous (i.v.) injection of Optiray 350(R). Data were collected between January 1994 and January 2000. The mean mGFR 1 yr after renal transplant was 63.6 +/- 19.9 mL/min/1.73 m2 in 26 live donor recipients and 50.8 +/- 23.3 mL/min/1.73 m2 in 35 cadaveric donors (p = 0.029). Correlation analysis showed significant negative associations of 1-yr mGFR with systolic blood pressure (SBP) and diastolic blood pressure (DBP) 3 months after renal Tx (r = - 0.58, p < 0.0001 and r = - 0.50, p < 0.0001, respectively), and with SBP (r = - 0.37, p = 0.003) and DBP (r = - 0.32, p = 0.01) 1 yr after renal Tx. Multi-variate regression analysis showed that the SBP 3 months after Tx (p < 0.001), number of acute rejections (p = 0.002), donor age (p = 0.02), and cold ischemia time (p = 0.03) were independent predictors for the 1-yr mGFR. These results indicate that a higher SBP in the first few months post-renal Tx is associated with decreased renal allograft function in children 1 yr post-Tx.
Mitsnefes
M M
MM
Division of Nephrology and Hypertension, Department of Pediatrics, University of Cincinnati College of Medicine and The Children's Hospital Research Foundation, Cincinnati, Ohio, USA.
Omoloja
A
A
McEnery
P T
PT
D000293:Adolescent; D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D002648:Child; D015331:Cohort Studies; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000503:physiopathology* / Q000601:surgery*; D007676:Kidney Failure, Chronic / Q000503:physiopathology* / Q000601:surgery*; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors