1. Tracking of blood pressure and its impact on graft function in pediatric renal transplant patients.
- Author
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Silverstein DM, Leblanc P, Hempe JM, Ramcharan T, and Boudreaux JP
- Subjects
- Child, Child, Preschool, Female, Follow-Up Studies, Glomerular Filtration Rate physiology, Graft Survival, Humans, Infant, Kidney Failure, Chronic physiopathology, Kidney Failure, Chronic surgery, Male, Retrospective Studies, Time Factors, Treatment Outcome, Blood Pressure physiology, Kidney Transplantation physiology
- 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.
- Published
- 2007
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