Sex and age as determinants for high blood pressure in pediatric renal transplant recipients: a longitudinal analysis of the CERTAIN Registry

Background High prevalence of arterial hypertension is known in pediatric renal transplant patients, but how blood pressure (BP) distribution and control differ between age groups and whether sex and age interact and potentially impact BP after transplantation have not been investigated. Methods Thi...

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Veröffentlicht in:Pediatric nephrology (Berlin, West) West), 2020-03, Vol.35 (3), p.415-426
Hauptverfasser: Sugianto, Rizky I., Schmidt, Bernhard M. W., Memaran, Nima, Duzova, Ali, Topaloglu, Rezan, Seeman, Tomas, König, Sabine, Dello Strologo, Luca, Murer, Luisa, Özçakar, Zeynep Birsin, Bald, Martin, Shenoy, Mohan, Buescher, Anja, Hoyer, Peter F., Pohl, Michael, Billing, Heiko, Oh, Jun, Staude, Hagen, Pohl, Martin, Genc, Gurkan, Klaus, Günter, Alparslan, Caner, Grenda, Ryszard, Rubik, Jacek, Krupka, Kai, Tönshoff, Burkhard, Wühl, Elke, Melk, Anette
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container_issue 3
container_start_page 415
container_title Pediatric nephrology (Berlin, West)
container_volume 35
creator Sugianto, Rizky I.
Schmidt, Bernhard M. W.
Memaran, Nima
Duzova, Ali
Topaloglu, Rezan
Seeman, Tomas
König, Sabine
Dello Strologo, Luca
Murer, Luisa
Özçakar, Zeynep Birsin
Bald, Martin
Shenoy, Mohan
Buescher, Anja
Hoyer, Peter F.
Pohl, Michael
Billing, Heiko
Oh, Jun
Staude, Hagen
Pohl, Martin
Genc, Gurkan
Klaus, Günter
Alparslan, Caner
Grenda, Ryszard
Rubik, Jacek
Krupka, Kai
Tönshoff, Burkhard
Wühl, Elke
Melk, Anette
description Background High prevalence of arterial hypertension is known in pediatric renal transplant patients, but how blood pressure (BP) distribution and control differ between age groups and whether sex and age interact and potentially impact BP after transplantation have not been investigated. Methods This retrospective analysis included 336 pediatric renal transplant recipients (62% males) from the Cooperative European Pediatric Renal Transplant Initiative Registry (CERTAIN) with complete BP measurement at discharge and 1, 2 and 3 years post-transplant. Results At discharge and 3 years post-transplant, arterial hypertension was highly prevalent (84% and 77%); antihypertensive drugs were used in 73% and 68% of the patients. 27% suffered from uncontrolled and 9% from untreated hypertension at 3 years post-transplant. Children transplanted at age < 5 years showed sustained high systolic BP z -score and received consistently less antihypertensive treatment over time. Younger age, shorter time since transplantation, male sex, higher body mass index (BMI), high cyclosporine A (CSA) trough levels, and a primary renal disease other than congenital anomalies of the kidney and urinary tract (CAKUT) were significantly associated with higher systolic BP z -score. Sex-stratified analysis revealed a significant association between high CSA and higher systolic BP in older girls that likely had started puberty already. An association between BP and estimated glomerular filtration rate was not detected. Conclusions BP control during the first 3 years was poor in this large European cohort. The description of age- and sex-specific risk profiles identified certain recipient groups that may benefit from more frequent BP monitoring (i.e. young children) or different choices of immunosuppression (i.e. older girls).
doi_str_mv 10.1007/s00467-019-04395-4
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W. ; Memaran, Nima ; Duzova, Ali ; Topaloglu, Rezan ; Seeman, Tomas ; König, Sabine ; Dello Strologo, Luca ; Murer, Luisa ; Özçakar, Zeynep Birsin ; Bald, Martin ; Shenoy, Mohan ; Buescher, Anja ; Hoyer, Peter F. ; Pohl, Michael ; Billing, Heiko ; Oh, Jun ; Staude, Hagen ; Pohl, Martin ; Genc, Gurkan ; Klaus, Günter ; Alparslan, Caner ; Grenda, Ryszard ; Rubik, Jacek ; Krupka, Kai ; Tönshoff, Burkhard ; Wühl, Elke ; Melk, Anette</creator><creatorcontrib>Sugianto, Rizky I. ; Schmidt, Bernhard M. W. ; Memaran, Nima ; Duzova, Ali ; Topaloglu, Rezan ; Seeman, Tomas ; König, Sabine ; Dello Strologo, Luca ; Murer, Luisa ; Özçakar, Zeynep Birsin ; Bald, Martin ; Shenoy, Mohan ; Buescher, Anja ; Hoyer, Peter F. ; Pohl, Michael ; Billing, Heiko ; Oh, Jun ; Staude, Hagen ; Pohl, Martin ; Genc, Gurkan ; Klaus, Günter ; Alparslan, Caner ; Grenda, Ryszard ; Rubik, Jacek ; Krupka, Kai ; Tönshoff, Burkhard ; Wühl, Elke ; Melk, Anette</creatorcontrib><description>Background High prevalence of arterial hypertension is known in pediatric renal transplant patients, but how blood pressure (BP) distribution and control differ between age groups and whether sex and age interact and potentially impact BP after transplantation have not been investigated. Methods This retrospective analysis included 336 pediatric renal transplant recipients (62% males) from the Cooperative European Pediatric Renal Transplant Initiative Registry (CERTAIN) with complete BP measurement at discharge and 1, 2 and 3 years post-transplant. Results At discharge and 3 years post-transplant, arterial hypertension was highly prevalent (84% and 77%); antihypertensive drugs were used in 73% and 68% of the patients. 27% suffered from uncontrolled and 9% from untreated hypertension at 3 years post-transplant. Children transplanted at age &lt; 5 years showed sustained high systolic BP z -score and received consistently less antihypertensive treatment over time. Younger age, shorter time since transplantation, male sex, higher body mass index (BMI), high cyclosporine A (CSA) trough levels, and a primary renal disease other than congenital anomalies of the kidney and urinary tract (CAKUT) were significantly associated with higher systolic BP z -score. Sex-stratified analysis revealed a significant association between high CSA and higher systolic BP in older girls that likely had started puberty already. An association between BP and estimated glomerular filtration rate was not detected. Conclusions BP control during the first 3 years was poor in this large European cohort. The description of age- and sex-specific risk profiles identified certain recipient groups that may benefit from more frequent BP monitoring (i.e. young children) or different choices of immunosuppression (i.e. older girls).</description><identifier>ISSN: 0931-041X</identifier><identifier>EISSN: 1432-198X</identifier><identifier>DOI: 10.1007/s00467-019-04395-4</identifier><identifier>PMID: 31811541</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject><![CDATA[Adolescent ; Age ; Age Factors ; Antihypertensives ; Blood pressure ; Blood Pressure Determination - statistics & numerical data ; Body mass index ; Cardiovascular diseases ; Child ; Child, Preschool ; Children ; Complications and side effects ; Congenital defects ; Cyclosporine - administration & dosage ; Cyclosporine - adverse effects ; Cyclosporine - pharmacokinetics ; Cyclosporins ; Diagnosis ; Europe - epidemiology ; Female ; Follow-Up Studies ; Glomerular filtration rate ; Graft Rejection - immunology ; Graft Rejection - prevention & control ; Health risk assessment ; Humans ; Hypertension ; Hypertension - diagnosis ; Hypertension - epidemiology ; Hypertension - etiology ; Immunosuppression ; Immunosuppressive agents ; Immunosuppressive Agents - administration & dosage ; Immunosuppressive Agents - adverse effects ; Immunosuppressive Agents - pharmacokinetics ; Kidney transplantation ; Kidney Transplantation - adverse effects ; Kidney transplants ; Kidneys ; Longitudinal Studies ; Male ; Medicine ; Medicine & Public Health ; Nephrology ; Original Article ; Patients ; Pediatric research ; Pediatrics ; Prevalence ; Puberty ; Registries - statistics & numerical data ; Retrospective Studies ; Risk factors ; Sex ; Sex Factors ; Tacrolimus - administration & dosage ; Tacrolimus - adverse effects ; Tacrolimus - pharmacokinetics ; Time Factors ; Transplant Recipients - statistics & numerical data ; Transplantation ; Transplants & implants ; Urinary tract ; Urology ; What’s new in Hypertension]]></subject><ispartof>Pediatric nephrology (Berlin, West), 2020-03, Vol.35 (3), p.415-426</ispartof><rights>IPNA 2019</rights><rights>COPYRIGHT 2020 Springer</rights><rights>Pediatric Nephrology is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c511t-627ea91d5d4a745affefbdcf37ad41c5da805aeba0b5af1dbf204e0604ad8e873</citedby><cites>FETCH-LOGICAL-c511t-627ea91d5d4a745affefbdcf37ad41c5da805aeba0b5af1dbf204e0604ad8e873</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00467-019-04395-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00467-019-04395-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31811541$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sugianto, Rizky I.</creatorcontrib><creatorcontrib>Schmidt, Bernhard M. W.</creatorcontrib><creatorcontrib>Memaran, Nima</creatorcontrib><creatorcontrib>Duzova, Ali</creatorcontrib><creatorcontrib>Topaloglu, Rezan</creatorcontrib><creatorcontrib>Seeman, Tomas</creatorcontrib><creatorcontrib>König, Sabine</creatorcontrib><creatorcontrib>Dello Strologo, Luca</creatorcontrib><creatorcontrib>Murer, Luisa</creatorcontrib><creatorcontrib>Özçakar, Zeynep Birsin</creatorcontrib><creatorcontrib>Bald, Martin</creatorcontrib><creatorcontrib>Shenoy, Mohan</creatorcontrib><creatorcontrib>Buescher, Anja</creatorcontrib><creatorcontrib>Hoyer, Peter F.</creatorcontrib><creatorcontrib>Pohl, Michael</creatorcontrib><creatorcontrib>Billing, Heiko</creatorcontrib><creatorcontrib>Oh, Jun</creatorcontrib><creatorcontrib>Staude, Hagen</creatorcontrib><creatorcontrib>Pohl, Martin</creatorcontrib><creatorcontrib>Genc, Gurkan</creatorcontrib><creatorcontrib>Klaus, Günter</creatorcontrib><creatorcontrib>Alparslan, Caner</creatorcontrib><creatorcontrib>Grenda, Ryszard</creatorcontrib><creatorcontrib>Rubik, Jacek</creatorcontrib><creatorcontrib>Krupka, Kai</creatorcontrib><creatorcontrib>Tönshoff, Burkhard</creatorcontrib><creatorcontrib>Wühl, Elke</creatorcontrib><creatorcontrib>Melk, Anette</creatorcontrib><title>Sex and age as determinants for high blood pressure in pediatric renal transplant recipients: a longitudinal analysis of the CERTAIN Registry</title><title>Pediatric nephrology (Berlin, West)</title><addtitle>Pediatr Nephrol</addtitle><addtitle>Pediatr Nephrol</addtitle><description>Background High prevalence of arterial hypertension is known in pediatric renal transplant patients, but how blood pressure (BP) distribution and control differ between age groups and whether sex and age interact and potentially impact BP after transplantation have not been investigated. Methods This retrospective analysis included 336 pediatric renal transplant recipients (62% males) from the Cooperative European Pediatric Renal Transplant Initiative Registry (CERTAIN) with complete BP measurement at discharge and 1, 2 and 3 years post-transplant. Results At discharge and 3 years post-transplant, arterial hypertension was highly prevalent (84% and 77%); antihypertensive drugs were used in 73% and 68% of the patients. 27% suffered from uncontrolled and 9% from untreated hypertension at 3 years post-transplant. Children transplanted at age &lt; 5 years showed sustained high systolic BP z -score and received consistently less antihypertensive treatment over time. Younger age, shorter time since transplantation, male sex, higher body mass index (BMI), high cyclosporine A (CSA) trough levels, and a primary renal disease other than congenital anomalies of the kidney and urinary tract (CAKUT) were significantly associated with higher systolic BP z -score. Sex-stratified analysis revealed a significant association between high CSA and higher systolic BP in older girls that likely had started puberty already. An association between BP and estimated glomerular filtration rate was not detected. Conclusions BP control during the first 3 years was poor in this large European cohort. The description of age- and sex-specific risk profiles identified certain recipient groups that may benefit from more frequent BP monitoring (i.e. young children) or different choices of immunosuppression (i.e. older girls).</description><subject>Adolescent</subject><subject>Age</subject><subject>Age Factors</subject><subject>Antihypertensives</subject><subject>Blood pressure</subject><subject>Blood Pressure Determination - statistics &amp; numerical data</subject><subject>Body mass index</subject><subject>Cardiovascular diseases</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Complications and side effects</subject><subject>Congenital defects</subject><subject>Cyclosporine - administration &amp; dosage</subject><subject>Cyclosporine - adverse effects</subject><subject>Cyclosporine - pharmacokinetics</subject><subject>Cyclosporins</subject><subject>Diagnosis</subject><subject>Europe - epidemiology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glomerular filtration rate</subject><subject>Graft Rejection - immunology</subject><subject>Graft Rejection - prevention &amp; control</subject><subject>Health risk assessment</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension - diagnosis</subject><subject>Hypertension - epidemiology</subject><subject>Hypertension - etiology</subject><subject>Immunosuppression</subject><subject>Immunosuppressive agents</subject><subject>Immunosuppressive Agents - administration &amp; dosage</subject><subject>Immunosuppressive Agents - adverse effects</subject><subject>Immunosuppressive Agents - pharmacokinetics</subject><subject>Kidney transplantation</subject><subject>Kidney Transplantation - adverse effects</subject><subject>Kidney transplants</subject><subject>Kidneys</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Nephrology</subject><subject>Original Article</subject><subject>Patients</subject><subject>Pediatric research</subject><subject>Pediatrics</subject><subject>Prevalence</subject><subject>Puberty</subject><subject>Registries - statistics &amp; numerical data</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>Sex</subject><subject>Sex Factors</subject><subject>Tacrolimus - administration &amp; dosage</subject><subject>Tacrolimus - adverse effects</subject><subject>Tacrolimus - pharmacokinetics</subject><subject>Time Factors</subject><subject>Transplant Recipients - statistics &amp; numerical data</subject><subject>Transplantation</subject><subject>Transplants &amp; implants</subject><subject>Urinary tract</subject><subject>Urology</subject><subject>What’s new in Hypertension</subject><issn>0931-041X</issn><issn>1432-198X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kmFr1TAUhoso7m76B_wgAcFvnUmbtqnfLpc5B0NhTti3cNqctBm9SU1S2P0R_mcz73QOLhJI4Jznfck5vFn2htFTRmnzIVDK6yanrM0pL9sq58-yFeNlkbNW3DzPVrQtWWqxm6PsOIRbSqmoRP0yOyqZYKzibJX9_IZ3BKwiMCCBQBRG9FtjwcZAtPNkNMNIusk5RWaPISweibFkRmUgetMTjxYmEj3YME9Jlgq9mQ0mg48EyOTsYOKizD0F6doFE4jTJI5INmdX1-uLL-QKBxOi373KXmiYAr5-eE-y75_Orjef88uv5xeb9WXeV4zFvC4ahJapSnFoeAVao-5Ur8sGFGd9pUDQCrAD2qUmU50uKEdaUw5KoGjKk-zd3nf27seCIcpbt_j0uSCLkpdV05ZCPFIDTCiN1S5N2W9N6OW6ZqxuGi6KROUHqAEtekjDozap_IQ_PcCno3Br-oOC9_8IRoQpjsFNSzTOhqdgsQd770LwqOXszRb8TjIq7xMj94mRKTHyd2IkT6K3D6tYui2qv5I_EUlAuQdCatkB_eOu_mP7CyClzDA</recordid><startdate>20200301</startdate><enddate>20200301</enddate><creator>Sugianto, Rizky I.</creator><creator>Schmidt, Bernhard M. 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W. ; Memaran, Nima ; Duzova, Ali ; Topaloglu, Rezan ; Seeman, Tomas ; König, Sabine ; Dello Strologo, Luca ; Murer, Luisa ; Özçakar, Zeynep Birsin ; Bald, Martin ; Shenoy, Mohan ; Buescher, Anja ; Hoyer, Peter F. ; Pohl, Michael ; Billing, Heiko ; Oh, Jun ; Staude, Hagen ; Pohl, Martin ; Genc, Gurkan ; Klaus, Günter ; Alparslan, Caner ; Grenda, Ryszard ; Rubik, Jacek ; Krupka, Kai ; Tönshoff, Burkhard ; Wühl, Elke ; Melk, Anette</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c511t-627ea91d5d4a745affefbdcf37ad41c5da805aeba0b5af1dbf204e0604ad8e873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>Age</topic><topic>Age Factors</topic><topic>Antihypertensives</topic><topic>Blood pressure</topic><topic>Blood Pressure Determination - statistics &amp; numerical data</topic><topic>Body mass index</topic><topic>Cardiovascular diseases</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Complications and side effects</topic><topic>Congenital defects</topic><topic>Cyclosporine - administration &amp; dosage</topic><topic>Cyclosporine - adverse effects</topic><topic>Cyclosporine - pharmacokinetics</topic><topic>Cyclosporins</topic><topic>Diagnosis</topic><topic>Europe - epidemiology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Glomerular filtration rate</topic><topic>Graft Rejection - immunology</topic><topic>Graft Rejection - prevention &amp; control</topic><topic>Health risk assessment</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension - diagnosis</topic><topic>Hypertension - epidemiology</topic><topic>Hypertension - etiology</topic><topic>Immunosuppression</topic><topic>Immunosuppressive agents</topic><topic>Immunosuppressive Agents - administration &amp; dosage</topic><topic>Immunosuppressive Agents - adverse effects</topic><topic>Immunosuppressive Agents - pharmacokinetics</topic><topic>Kidney transplantation</topic><topic>Kidney Transplantation - adverse effects</topic><topic>Kidney transplants</topic><topic>Kidneys</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine &amp; Public Health</topic><topic>Nephrology</topic><topic>Original Article</topic><topic>Patients</topic><topic>Pediatric research</topic><topic>Pediatrics</topic><topic>Prevalence</topic><topic>Puberty</topic><topic>Registries - statistics &amp; numerical data</topic><topic>Retrospective Studies</topic><topic>Risk factors</topic><topic>Sex</topic><topic>Sex Factors</topic><topic>Tacrolimus - administration &amp; dosage</topic><topic>Tacrolimus - adverse effects</topic><topic>Tacrolimus - pharmacokinetics</topic><topic>Time Factors</topic><topic>Transplant Recipients - statistics &amp; numerical data</topic><topic>Transplantation</topic><topic>Transplants &amp; implants</topic><topic>Urinary tract</topic><topic>Urology</topic><topic>What’s new in Hypertension</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sugianto, Rizky I.</creatorcontrib><creatorcontrib>Schmidt, Bernhard M. W.</creatorcontrib><creatorcontrib>Memaran, Nima</creatorcontrib><creatorcontrib>Duzova, Ali</creatorcontrib><creatorcontrib>Topaloglu, Rezan</creatorcontrib><creatorcontrib>Seeman, Tomas</creatorcontrib><creatorcontrib>König, Sabine</creatorcontrib><creatorcontrib>Dello Strologo, Luca</creatorcontrib><creatorcontrib>Murer, Luisa</creatorcontrib><creatorcontrib>Özçakar, Zeynep Birsin</creatorcontrib><creatorcontrib>Bald, Martin</creatorcontrib><creatorcontrib>Shenoy, Mohan</creatorcontrib><creatorcontrib>Buescher, Anja</creatorcontrib><creatorcontrib>Hoyer, Peter F.</creatorcontrib><creatorcontrib>Pohl, Michael</creatorcontrib><creatorcontrib>Billing, Heiko</creatorcontrib><creatorcontrib>Oh, Jun</creatorcontrib><creatorcontrib>Staude, Hagen</creatorcontrib><creatorcontrib>Pohl, Martin</creatorcontrib><creatorcontrib>Genc, Gurkan</creatorcontrib><creatorcontrib>Klaus, Günter</creatorcontrib><creatorcontrib>Alparslan, Caner</creatorcontrib><creatorcontrib>Grenda, Ryszard</creatorcontrib><creatorcontrib>Rubik, Jacek</creatorcontrib><creatorcontrib>Krupka, Kai</creatorcontrib><creatorcontrib>Tönshoff, Burkhard</creatorcontrib><creatorcontrib>Wühl, Elke</creatorcontrib><creatorcontrib>Melk, Anette</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium &amp; Calcified Tissue Abstracts</collection><collection>Nursing &amp; Allied Health Database</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>Pediatric nephrology (Berlin, West)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sugianto, Rizky I.</au><au>Schmidt, Bernhard M. W.</au><au>Memaran, Nima</au><au>Duzova, Ali</au><au>Topaloglu, Rezan</au><au>Seeman, Tomas</au><au>König, Sabine</au><au>Dello Strologo, Luca</au><au>Murer, Luisa</au><au>Özçakar, Zeynep Birsin</au><au>Bald, Martin</au><au>Shenoy, Mohan</au><au>Buescher, Anja</au><au>Hoyer, Peter F.</au><au>Pohl, Michael</au><au>Billing, Heiko</au><au>Oh, Jun</au><au>Staude, Hagen</au><au>Pohl, Martin</au><au>Genc, Gurkan</au><au>Klaus, Günter</au><au>Alparslan, Caner</au><au>Grenda, Ryszard</au><au>Rubik, Jacek</au><au>Krupka, Kai</au><au>Tönshoff, Burkhard</au><au>Wühl, Elke</au><au>Melk, Anette</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sex and age as determinants for high blood pressure in pediatric renal transplant recipients: a longitudinal analysis of the CERTAIN Registry</atitle><jtitle>Pediatric nephrology (Berlin, West)</jtitle><stitle>Pediatr Nephrol</stitle><addtitle>Pediatr Nephrol</addtitle><date>2020-03-01</date><risdate>2020</risdate><volume>35</volume><issue>3</issue><spage>415</spage><epage>426</epage><pages>415-426</pages><issn>0931-041X</issn><eissn>1432-198X</eissn><abstract>Background High prevalence of arterial hypertension is known in pediatric renal transplant patients, but how blood pressure (BP) distribution and control differ between age groups and whether sex and age interact and potentially impact BP after transplantation have not been investigated. Methods This retrospective analysis included 336 pediatric renal transplant recipients (62% males) from the Cooperative European Pediatric Renal Transplant Initiative Registry (CERTAIN) with complete BP measurement at discharge and 1, 2 and 3 years post-transplant. Results At discharge and 3 years post-transplant, arterial hypertension was highly prevalent (84% and 77%); antihypertensive drugs were used in 73% and 68% of the patients. 27% suffered from uncontrolled and 9% from untreated hypertension at 3 years post-transplant. Children transplanted at age &lt; 5 years showed sustained high systolic BP z -score and received consistently less antihypertensive treatment over time. Younger age, shorter time since transplantation, male sex, higher body mass index (BMI), high cyclosporine A (CSA) trough levels, and a primary renal disease other than congenital anomalies of the kidney and urinary tract (CAKUT) were significantly associated with higher systolic BP z -score. Sex-stratified analysis revealed a significant association between high CSA and higher systolic BP in older girls that likely had started puberty already. An association between BP and estimated glomerular filtration rate was not detected. Conclusions BP control during the first 3 years was poor in this large European cohort. The description of age- and sex-specific risk profiles identified certain recipient groups that may benefit from more frequent BP monitoring (i.e. young children) or different choices of immunosuppression (i.e. older girls).</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>31811541</pmid><doi>10.1007/s00467-019-04395-4</doi><tpages>12</tpages></addata></record>
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identifier ISSN: 0931-041X
ispartof Pediatric nephrology (Berlin, West), 2020-03, Vol.35 (3), p.415-426
issn 0931-041X
1432-198X
language eng
recordid cdi_proquest_journals_2343579388
source MEDLINE; SpringerLink Journals
subjects Adolescent
Age
Age Factors
Antihypertensives
Blood pressure
Blood Pressure Determination - statistics & numerical data
Body mass index
Cardiovascular diseases
Child
Child, Preschool
Children
Complications and side effects
Congenital defects
Cyclosporine - administration & dosage
Cyclosporine - adverse effects
Cyclosporine - pharmacokinetics
Cyclosporins
Diagnosis
Europe - epidemiology
Female
Follow-Up Studies
Glomerular filtration rate
Graft Rejection - immunology
Graft Rejection - prevention & control
Health risk assessment
Humans
Hypertension
Hypertension - diagnosis
Hypertension - epidemiology
Hypertension - etiology
Immunosuppression
Immunosuppressive agents
Immunosuppressive Agents - administration & dosage
Immunosuppressive Agents - adverse effects
Immunosuppressive Agents - pharmacokinetics
Kidney transplantation
Kidney Transplantation - adverse effects
Kidney transplants
Kidneys
Longitudinal Studies
Male
Medicine
Medicine & Public Health
Nephrology
Original Article
Patients
Pediatric research
Pediatrics
Prevalence
Puberty
Registries - statistics & numerical data
Retrospective Studies
Risk factors
Sex
Sex Factors
Tacrolimus - administration & dosage
Tacrolimus - adverse effects
Tacrolimus - pharmacokinetics
Time Factors
Transplant Recipients - statistics & numerical data
Transplantation
Transplants & implants
Urinary tract
Urology
What’s new in Hypertension
title Sex and age as determinants for high blood pressure in pediatric renal transplant recipients: a longitudinal analysis of the CERTAIN Registry
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