Masked hypertension and hidden uncontrolled hypertension after renal transplantation.
Arterial hypertension is a risk factor affecting graft function in pediatric kidney transplants. Recent pediatric studies reported a high prevalence of hypertension, especially nocturnal hypertension in this population. Data regarding the prevalence of masked hypertension in pediatric patients with kidney transplants are still scarce. The aim of this cross-sectional study was to assess the prevalence of masked and hidden uncontrolled hypertension after renal transplantation. A total of 41 patients (25 males) with stable functioning renal graft were included in the study. Their median age was 14.5 years with the median interval since transplantation of 2.5 years (range 0.3 to 20.6). Spacelabs 90207 was used to measure ambulatory blood pressure (BP) during a 24-h period. Ambulatory hypertension was defined as mean systolic and/or diastolic BP index at day-time or nighttime >or=1. Masked hypertension was defined as normal office BP but daytime ambulatory hypertension in patients without antihypertensive medications. Hidden uncontrolled hypertension was defined as daytime ambulatory hypertension undetected by office BP measurements in treated patients. Antihypertensive medications were prescribed to 58%. Prevalence of nocturnal hypertension was 68%. On the basis of combination of office and ABPM masked hypertension and hidden uncontrolled hypertension was detected in 24% and 21% of the study population, respectively. Regular use of ambulatory blood pressure monitoring in transplanted patients enables detection of masked and hidden uncontrolled hypertension.
Paripovic
Dusan
D
Nephrology Department, University Children's Hospital, Tirsova 10, 11 000 Belgrade, Serbia. para@eunet.rs
Kostic
Mirjana
M
Spasojevic
Brankica
B
Kruscic
Divna
D
Peco-Antic
Amira
A
D000293:Adolescent; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D009819:Office Visits; D015995:Prevalence; D055771:Serbia / Q000453:epidemiology; D013997:Time Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
D000959:Antihypertensive Agents
J Pediatr. 1997 Feb;130(2):178-84
9042117
Am J Hypertens. 2005 Nov;18(11):1408-14
16280272
Hypertension. 2002 Dec;40(6):795-6
12468559
Pediatr Nephrol. 2009 May;24(5):959-72
17955265
Pediatr Transplant. 2006 Aug;10(5):558-64
16856991
Pediatr Transplant. 2007 Aug;11(5):491-7
17631016
Pediatr Transplant. 2003 Apr;7(2):86-92
12654047
Clin Transplant. 2005 Apr;19(2):181-92
15740553
J Am Soc Nephrol. 2010 Jan;21(1):137-44
19917781
Srp Arh Celok Lek. 1997 May-Jun;125(5-6):171-5
9265240
Pediatr Nephrol. 1994 Oct;8(5):570-3
7819003
Am J Hypertens. 1998 Apr;11(4 Pt 1):497-501
9607390
Hypertension. 2002 Apr;39(4):903-8
11967247
Pediatr Transplant. 2006 May;10(3):316-22
16677355
Pediatr Transplant. 2007 Dec;11(8):906-13
17976127
Pediatr Transplant. 2007 Feb;11(1):24-30
17239120
Pediatrics. 2004 Aug;114(2 Suppl 4th Report):555-76
15286277
Transplantation. 2009 Oct 27;88(8):1030-7
19855250
N Engl J Med. 1990 May 31;322(22):1561-6
2139921
Pediatr Transplant. 2005 Oct;9(5):612-7
16176418
J Hypertens. 2007 Jun;25(6):1105-87
17563527
Am J Hypertens. 2008 Sep;21(9):969-75
18583985
Pediatr Nephrol. 2005 Aug;20(8):1151-5
15947982
Circulation. 2004 Jul 6;110(1):97-101
15210594
J Am Soc Nephrol. 1999 Jun;10(6):1324-30
10361872
Am J Hypertens. 2008 Oct;21(10):1093-9
18704114
Pediatr Nephrol. 2004 Jun;19(6):651-4
15071772
Hypertension. 2005 Apr;45(4):493-8
15767467
Srp Arh Celok Lek. 2008 Jan-Feb;136(1-2):62-7
18410040
Pediatr Nephrol. 1997 Feb;11(1):23-6
9035167