Antihypertensive pharmacotherapy and long‐term outcomes in pediatric kidney transplantation. (6th May 2013)

• Record Type: Journal Article
• Authors: Suszynski, Thomas M.; Rizzari, Michael D.; Gillingham, Kristen J.; Rheault, Michelle N.; Kraszkiewicz, Wojciech; Matas, Arthur J.; Chavers, Blanche M.
• Is Part Of: Clinical transplantation. Volume 27:Number 3(2013:May/Jun.)
• Page Start: 472
• Page End: 480
• Publication Date: 2013-05-06
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.12125
• Languages: English
• ISSNs: 0902-0063

Abstract

<abstract abstract-type="main" id="ctr12125-abs-0001"> <title>Abstract</title> <p>Hypertension (HTN) is common in pediatric recipients following kidney transplantation (KT). We retrospectively assessed the impact of HTN on long‐term (&gt;10‐yr) outcomes in pediatric KT recipients (aged &lt; 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 &gt;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.</p> </abstract>