title: Tracking of blood pressure and its impact on graft function in pediatric renal transplant patients.
abstract: We studied tracking of BP and its impact on GFR in 44 PRTP followed for 56 months. Three months PT 77% had elevated SBP percentile. First year SBP and DBP correlated positively with final values (p < 0.0001, 0.0002, respectively). Pretransplant and three month PT SBP correlated positively (p = 0.02). At one yr, SBP and DBP were inversely associated with GFR (p = 0.002, p < 0.0001, respectively). SBP and BMI were positively associated at all time points. DBP was significantly higher in deceased recipients throughout the study period. Final DBP was higher (p = 0.03) and GFR lower (p = 0.04) in African-American patients. Patients with end-stage renal disease caused by glomerular disease had higher SBP (p = 0.03) and DBP (p = 0.04) than those with congenital malformations. GFR at one-yr PT (p = 0.02) and end of study (p = 0.003) was significantly lower in patients with high BP. Moreover, patients who maintained a normal systolic BP throughout the study had a significantly higher final GFR than those who were hypertensive at both time points [84 (normal BP throughout) vs. 52 mL/min/1.73 m(2) (high BP throughout), p = 0.02]. We conclude that PT hypertension is common in PRTP and predicts lower GFR.
authors.affiliation: Division of Nephrology, Department of Pediatrics, Louisiana State University Health Sciences Center, New Orleans, LA, USA. dsilvers@cnmc.org
authors.forename: Douglas M
authors.initials: DM
authors.lastname: Silverstein
authors.forename: Pamela
authors.initials: P
authors.lastname: Leblanc
authors.forename: James M
authors.initials: JM
authors.lastname: Hempe
authors.forename: Thiagarajan
authors.initials: T
authors.lastname: Ramcharan
authors.forename: J Philip
authors.initials: JP
authors.lastname: Boudreaux
mesh_terms: D001794:Blood Pressure / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology; D006085:Graft Survival; D006801:Humans; D007223:Infant; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000601:surgery; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome