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Improved control of hypertension in children after renal transplantation: Results of a two‐yr interventional trial
Author(s) -
Seeman Tomáš,
Šimková Eva,
Kreisinger Jiří,
Vondrák Karel,
Dušek Jiří,
Gilík Jiří,
Dvořák Pavel,
Janda Jan
Publication year - 2007
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2006.00661.x
Subject(s) - medicine , transplantation , ambulatory , kidney transplantation , prospective cohort study , antihypertensive drug , ambulatory blood pressure , pediatrics , blood pressure
Hypertension is a frequent complication in children after renal transplantation and the control of post‐transplant hypertension is unsatisfactorily low. The aim of this prospective interventional study was to improve the control of hypertension in children after renal transplantation. Thirty‐six children fulfilled the inclusion criteria (≥6 months after transplantation and no acute rejection in the last three months). BP was measured using ABPM. Hypertension was defined as mean ambulatory BP ≥95th‐centile for healthy children and/or using antihypertensive drugs. The study intervention consisted of using intensified antihypertensive drug therapy – in children with uncontrolled hypertension (i.e., mean ambulatory BP was ≥95th centile in treated children), antihypertensive therapy was intensified by adding new antihypertensive drugs to reach goal BP <95th centile. ABPM was repeated after 12 and 24 months. Daytime BP did not change significantly after 12 or 24 months. Night‐time BP decreased from 1.57 ± 1.33 to 0.88 ± 0.84 SDS for systolic and from 1.10 ± 1.51 to 0.35 ± 1.18 SDS for diastolic BP after 24 months (p < 0.05). The number of antihypertensive drugs increased from 2.1 ± 0.9 to 2.7 ± 0.8 drugs per patient (p < 0.05), this was especially seen with the use of ACE‐inhibitors (increase from 19% to 40% of children, p < 0.05). In conclusion, this interventional trial demonstrated that, in children after renal transplantation, the control of hypertension, especially at night‐time, can be improved by increasing the number of antihypertensive drugs, especially ACE‐inhibitors.