title: An observational cohort study of the effect of hypertension on the loss of renal function in pediatric kidney recipients.
abstract: BACKGROUND
  Post-transplant hypertension impacts negatively on renal graft survival. Our primary objective was to analyze the effect of hypertension on the glomerular filtration rate (GFR) slope.
  
  
  METHODS
  All clinical charts of children who underwent renal transplantation since the introduction of the routine use of ambulatory blood pressure monitoring (ABPM) were reviewed. Eligibility criteria for inclusion were measurement of GFR at 3 months, at 1 year post-transplant, and thereafter at yearly intervals; ABPM performed annually after transplantation; and functioning graft for a minimum of 2 years.
  
  
  RESULTS
  Sixty-eight (39 males) of 79 patients, aged 9.1±5.3 years, met the inclusion criteria. The mean follow-up was 6.2±2.8 years. Twenty-four patients had normotension or controlled hypertension throughout their follow-up (normotensive group). Forty-four patients had hypertension or noncontrolled hypertension at some point(s) during the follow-up period (hypertensive group). GFR slope was -1.6ml/min/1.73 m(2) per year (95% confidence interval (CI = -3.7 to 0.4) in the normotensive group and -2ml/min/1.73 m(2) per year (95% CI = -3 to -1.1) in the hypertensive group (P = 0.42). There was no difference between groups with regard to the change in GFR values from 3 months to 1 year and to last control (P = 0.87). At most recent control, the overall prevalence of controlled hypertension was 78.2% (95% CI = 63.6-89.1).
  
  
  CONCLUSIONS
  Although the results of our study are encouraging, they need to be confirmed in a larger prospective study using the same post-transplant follow-up protocol.
authors: Department for Clinical Science, Intervention and Technology, Division of Pediatrics, Karolinska University Hospital, Huddinge, Sweden.
authors: Camilla
authors: C
authors: Cameron
authors: Georgios
authors: G
authors: Vavilis
authors: Jan
authors: J
authors: Kowalski
authors: Gunnar
authors: G
authors: Tydén
authors: Ulla B
authors: UB
authors: Berg
authors: Rafael T
authors: RT
authors: Krmar
mesh_terms: D000293:Adolescent; D018660:Blood Pressure Monitoring, Ambulatory; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006085:Graft Survival; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D007223:Infant; D007668:Kidney / Q000503:physiopathology*; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D012189:Retrospective Studies
keywords: ambulatory blood pressure monitoring; blood pressure; glomerular filtration rate; hypertension; left ventricular hypertrophy; pediatrics; transplantation.