Total peripheral vascular resistance in pediatric renal transplant patients.
BACKGROUND
Abnormal cardiovascular reactivity at rest and during physical exercise may be a risk factor for left ventricular hypertrophy (LVH) in pediatric renal transplanted (Tx) patients. Data on total peripheral vascular resistance (TPR) are not available.


METHODS
Eleven renal Tx patients treated with cyclosporine (7 females and 4 males; mean age 14.6 +/- 3.3 years; mean time since transplantation 43 +/- 35 months) were evaluated for 24-hour blood pressure (BP), TPR and echocardiographic left ventricular mass (LVM). TPR values of patients were compared with data of a group of 11 healthy controls matched for sex and age.


RESULTS
Twenty-four-hour ambulatory blood pressure monitoring showed that all but one patient had normal daytime BP values and six patients showed a reduced or inverse nocturnal dip. LVH was found in 72% of the patients. In comparison with healthy controls, patients showed significantly elevated TPR at rest and during exercise suggesting an increased vascular tone. The degree of LVH in these patients is severe and appears disproportionate to the BP values.


CONCLUSIONS
The high incidence of LVH can reflect an augmented cardiovascular reactivity associated with a disturbed circadian pattern. The increase in TPR and the reduction of the nocturnal fall of BP also might contribute to the development of LVH in young renal Tx patients.
Matteucci
Maria Chiara
MC
Department of Pediatric Nephrology and Unit of Sports Medicine, Bambino Gesù Children Research Hospital, Rome, Italy. matteucc@opbg.edu
Giordano
Ugo
U
Calzolari
Armando
A
Rizzoni
Gianfranco
G
D000293:Adolescent; D001794:Blood Pressure; D002302:Cardiac Output; D002648:Child; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology*; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D014655:Vascular Resistance