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Antihypertensive pharmacotherapy and long-term outcomes in pediatric kidney transplantation.
- Source :
-
Clinical transplantation [Clin Transplant] 2013 May-Jun; Vol. 27 (3), pp. 472-80. Date of Electronic Publication: 2013 May 06. - Publication Year :
- 2013
-
Abstract
- Hypertension (HTN) is common in pediatric recipients following kidney transplantation (KT). We retrospectively assessed the impact of HTN on long-term (>10-yr) outcomes in pediatric KT recipients (aged < 18 yr) at our center. Two hundred and ninety-three pediatric KT recipients (83% living donor [LD]) with graft survival (GS) for ≥5 yr were studied. HTN was defined by antihypertensive medication use at five yr post-KT. One hundred and sixty (55%) recipients did not have HTN, and 133 (45%) had HTN at five yr post-KT. There were no differences in actuarial patient survival between cohorts. Actuarial GS at 15 and 20 yr was 68% and 53% for recipients without HTN, and 53% and 33% for recipients with HTN (p = 0.006). Among LD recipients using one antihypertensive, GS at 15 yr was 100% for those using an angiotensin-converting enzyme inhibitor (ACEI) and 44% for those not using an ACEI (p = 0.04). Among these recipients, HTN treated with no ACEI was a significant risk factor for graft failure at >5 yr (hazard ratio [HR] = 2.5, p = 0.02), but HTN treated with an ACEI was not (HR = 0.6, p = 0.7). HTN at five yr post-KT is associated with poorer long-term GS in pediatric recipients, but ACEI therapy may enable better outcomes and should be studied further.<br /> (© 2013 John Wiley & Sons A/S.)
- Subjects :
- Adolescent
Antihypertensive Agents therapeutic use
Child
Child, Preschool
Female
Follow-Up Studies
Graft Rejection drug therapy
Graft Rejection etiology
Humans
Hypertension drug therapy
Hypertension etiology
Kidney Diseases mortality
Kidney Diseases surgery
Kidney Transplantation mortality
Male
Prognosis
Retrospective Studies
Risk Factors
Survival Rate
Time Factors
Graft Rejection mortality
Graft Survival
Hypertension mortality
Kidney Diseases complications
Kidney Transplantation adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1399-0012
- Volume :
- 27
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Clinical transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 23647497
- Full Text :
- https://doi.org/10.1111/ctr.12125