PMID- 22287656 OWN - NLM STAT- MEDLINE DCOM- 20121218 LR - 20120717 IS - 1460-2385 (Electronic) IS - 0931-0509 (Linking) VI - 27 IP - 7 DP - 2012 Jul TI - Progression to hypertension in non-hypertensive children following renal transplantation. PG - 2990-6 LID - 10.1093/ndt/gfr784 [doi] AB - BACKGROUND: The aim of this study was to evaluate in non-hypertensive children following renal transplantation (TX) the rates and determinants of transition to hypertension. METHODS: Retrospective case note review of all current paediatric kidney transplant patients in the UK. At baseline (6 months following TX), all included subjects were non-hypertensive with systolic and/or diastolic clinic blood pressure (BP) /=50th but <90th percentile) and pre-hypertension (systolic and/or diastolic clinic BP 90th-95th percentile) to hypertension (systolic and/or diastolic clinic BP>95th percentile). If systolic and diastolic BP levels belonged to different categories, the higher of the two levels were used for categorization. RESULTS: At baseline, 146 of 524 (27.9%) children (106 male) median [inter-quartile range (IQR)] age 7.8 years (4.8, 11.8) were non-hypertensive and not on any anti-hypertensive therapy; there were 34 patients (23.2%) with optimal BP, 90 (61.6%) with normal BP and 22 (15.1%) with pre-hypertension. They were followed up for a median of 2.0 (1.0, 4.0) years post-TX. At the end of follow-up, BP was optimal in 37 patients (25.3%), normal in 35 (24.0%), high normal in 2 (1.4%) and 72 (49.3%) had progressed to hypertension. The Kaplan-Meier estimated time at which 50% of patients developed hypertension was 2.0 years for the pre-hypertension and 3.0 years in the normal BP group as opposed to 40% risk at 7-year post-TX in the optimal group (P=0.001 between the three groups). The differences between BP groups remained significant after adjustment for all risk factors on multivariate analysis. CONCLUSIONS: Just over 49% of our initially non-hypertensive patients progressed to hypertension following TX. BP needs careful monitoring post-TX and ideally should be maintained in the 'normal' and 'optimal' range. FAU - Sinha, Manish D AU - Sinha MD AD - Department of Paediatric Nephrology, Evelina Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK. manish.sinha@gstt.nhs.uk FAU - Gilg, Julie A AU - Gilg JA FAU - Kerecuk, Larissa AU - Kerecuk L FAU - Reid, Christopher J D AU - Reid CJ CN - British Association for Paediatric Nephrology LA - eng GR - Department of Health/United Kingdom PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20120128 PL - England TA - Nephrol Dial Transplant JT - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JID - 8706402 RN - 0 (Antihypertensive Agents) SB - IM MH - Adolescent MH - Antihypertensive Agents/therapeutic use MH - Blood Pressure Monitoring, Ambulatory MH - Child MH - Child, Preschool MH - Disease Progression MH - Female MH - Follow-Up Studies MH - Glomerular Filtration Rate MH - Humans MH - Hypertension/drug therapy/*etiology/*mortality MH - Kidney Transplantation/*adverse effects MH - Male MH - Prognosis MH - Renal Insufficiency, Chronic/*complications/mortality/surgery MH - Retrospective Studies MH - Risk Factors MH - Survival Rate EDAT- 2012/01/31 06:00 MHDA- 2012/12/19 06:00 CRDT- 2012/01/31 06:00 PHST- 2012/01/31 06:00 [entrez] PHST- 2012/01/31 06:00 [pubmed] PHST- 2012/12/19 06:00 [medline] AID - gfr784 [pii] AID - 10.1093/ndt/gfr784 [doi] PST - ppublish SO - Nephrol Dial Transplant. 2012 Jul;27(7):2990-6. doi: 10.1093/ndt/gfr784. Epub 2012 Jan 28.