Abstract
The incidence of hypertension was sought in 102 children who had undergone renal transplantation. Fifty five were being treated with cyclosporin and 47 with azathioprine, and they were followed up for a maximum of five years. After one year 35 of those receiving cyclosporin (64%) and 34 of those receiving azathioprine (72%) were hypertensive; after five years the figures were 5/6 (83%) and 25/35 (71%), respectively. Recipients of grafts from living related donors had a lower incidence of hypertension than recipients of cadaveric grafts. The incidence of hypertension was higher in patients with acquired original kidney disease than in children with congenital or familial diseases. In both groups creatinine clearance and the frequency of acute rejection episodes did not differ between normotensive and hypertensive patients. When the lowest concentrations of cyclosporin in whole blood were more than 400 ng/ml the incidence of hypertension one year after transplantation was higher. The incidence of hypertension after renal transplantation in children is higher than that reported in adults. Acquired original disease, transplantation of cadaveric grafts, and nephrotoxicity of cyclosporin are all contributory factors.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bennett W. M., Porter G. A. Cyclosporine-associated hypertension. Am J Med. 1988 Aug;85(2):131–133. doi: 10.1016/s0002-9343(88)80330-9. [DOI] [PubMed] [Google Scholar]
- Broyer M., Guest G., Gagnadoux M. F., Beurton D. Hypertension following renal transplantation in children. Pediatr Nephrol. 1987 Jan;1(1):16–21. doi: 10.1007/BF00866879. [DOI] [PubMed] [Google Scholar]
- Chapman J. R., Marcen R., Arias M., Raine A. E., Dunnill M. S., Morris P. J. Hypertension after renal transplantation. A comparison of cyclosporine and conventional immunosuppression. Transplantation. 1987 Jun;43(6):860–864. [PubMed] [Google Scholar]
- Curtis J. J., Luke R. G., Diethelm A. G., Whelchel J. D., Jones P. Benefits of removal of native kidneys in hypertension after renal transplantation. Lancet. 1985 Oct 5;2(8458):739–742. doi: 10.1016/s0140-6736(85)90627-0. [DOI] [PubMed] [Google Scholar]
- Curtis J. J., Luke R. G., Jones P., Diethelm A. G. Hypertension in cyclosporine-treated renal transplant recipients is sodium dependent. Am J Med. 1988 Aug;85(2):134–138. doi: 10.1016/s0002-9343(88)80331-0. [DOI] [PubMed] [Google Scholar]
- Curtis J. J., Luke R. G., Jones P., Diethelm A. G., Whelchel J. D. Hypertension after successful renal transplantation. Am J Med. 1985 Aug;79(2):193–200. doi: 10.1016/0002-9343(85)90009-9. [DOI] [PubMed] [Google Scholar]
- Henriksson C., Nilson A. E., Thorén O. K. Artery steonsis in renal transplantation. Scand J Urol Nephrol. 1975 Mar 6;(29 Suppl):89–90. [PubMed] [Google Scholar]
- Hoyer P. F., Krohn H. P., Offner G., Byrd D. J., Brodehl J., Wonigeit K., Pichlmayr R. Renal function after kidney transplantation in children. A comparison of conventional immunosuppression with cyclosporine. Transplantation. 1987 Apr;43(4):489–493. doi: 10.1097/00007890-198704000-00006. [DOI] [PubMed] [Google Scholar]
- Hoyer P. F., Offner G., Wonigeit K., Brodehl J., Pichlmayr R. Dosage of Cyclosporin A in children with renal transplants. Clin Nephrol. 1984 Aug;22(2):68–71. [PubMed] [Google Scholar]
- Jacquot C., Idatte J. M., Bedrossian J., Weiss Y., Safar M., Bariety J. Long-term blood pressure changes in renal homotransplantation. Arch Intern Med. 1978 Feb;138(2):233–236. [PubMed] [Google Scholar]
- Kirkman R. L., Strom T. B., Weir M. R., Tilney N. L. Late mortality and morbidity in recipients of long-term renal allografts. Transplantation. 1982 Dec;34(6):347–351. doi: 10.1097/00007890-198212000-00007. [DOI] [PubMed] [Google Scholar]
- Luke R. G., Curtis J. J., Jones P., Whelchel J. D., Diethelm A. G. Mechanisms of posttransplant hypertension. Am J Kidney Dis. 1985 Apr;5(4):A79–A84. doi: 10.1016/s0272-6386(85)80069-x. [DOI] [PubMed] [Google Scholar]
- Luke R. G. Hypertension in renal transplant recipients. Kidney Int. 1987 Apr;31(4):1024–1037. doi: 10.1038/ki.1987.102. [DOI] [PubMed] [Google Scholar]
- McHugh M. I., Tanboga H., Marcen R., Liano F., Robson V., Wilkinson R. Hypertension following renal transplantation: the role of the host's kidney. Q J Med. 1980 Autumn;49(196):395–403. [PubMed] [Google Scholar]
- McHugh M. I., Tanboga H., Wilkinson R. Alternate day steroids and blood pressure control after renal transplantation. Proc Eur Dial Transplant Assoc. 1980;17:496–501. [PubMed] [Google Scholar]
- Myers B. D., Sibley R., Newton L., Tomlanovich S. J., Boshkos C., Stinson E., Luetscher J. A., Whitney D. J., Krasny D., Coplon N. S. The long-term course of cyclosporine-associated chronic nephropathy. Kidney Int. 1988 Feb;33(2):590–600. doi: 10.1038/ki.1988.38. [DOI] [PubMed] [Google Scholar]
- Offner G., Brandis M., Brodehl J., Krohn H. P., Pichlmayr R., Tidow G. Nierentransplantationen bei Kindern in Hannover 1970-1977. Dtsch Med Wochenschr. 1979 Mar 16;104(11):393–401. doi: 10.1055/s-0028-1103917. [DOI] [PubMed] [Google Scholar]
- Report of the Second Task Force on Blood Pressure Control in Children--1987. Task Force on Blood Pressure Control in Children. National Heart, Lung, and Blood Institute, Bethesda, Maryland. Pediatrics. 1987 Jan;79(1):1–25. [PubMed] [Google Scholar]
- Ribot S., Byrd L. Letter: Post-renal-transplant hypertension. N Engl J Med. 1976 Feb 5;294(6):342–342. doi: 10.1056/nejm197602052940622. [DOI] [PubMed] [Google Scholar]
- Schwartz G. J., Haycock G. B., Edelmann C. M., Jr, Spitzer A. A simple estimate of glomerular filtration rate in children derived from body length and plasma creatinine. Pediatrics. 1976 Aug;58(2):259–263. [PubMed] [Google Scholar]
- Tejani A. Post-transplant hypertension and hypertensive encephalopathy in renal allograft recipients. Nephron. 1983;34(2):73–78. doi: 10.1159/000182985. [DOI] [PubMed] [Google Scholar]
- Waltzer W. C., Turner S., Frohnert P., Rapaport F. T. Etiology and pathogenesis of hypertension following renal transplantation. Nephron. 1986;42(2):102–109. doi: 10.1159/000183646. [DOI] [PubMed] [Google Scholar]