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Pediatric Nephrology
Erschienen in: Pediatric Nephrology 11/2017

13.08.2017 | Original Article

Factors associated with cardiovascular target organ damage in children after renal transplantation

verfasst von: Bianca Borchert-Mörlins, Daniela Thurn, Bernhard M. W. Schmidt, Anja K. Büscher, Jun Oh, Tanja Kier, Elena Bauer, Sabrina Baig, Nele Kanzelmeyer, Markus J. Kemper, Rainer Büscher, Anette Melk

Erschienen in: Pediatric Nephrology | Ausgabe 11/2017

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Abstract

Background

Cardiovascular disease is the second-most common cause of death in pediatric renal transplant recipients. The aim of this study was to evaluate subclinical cardiovascular target organ damage defined as the presence of arterio- and atherosclerotic lesions and cardiac remodeling and to analyze contributing risk factors in a large cohort of children after renal transplantation (RT).

Methods

A total of 109 children aged 13.1 ± 3.3 years who had undergone RT at one of three German transplant centers were enrolled in this study. Patients had been transplanted a mean of 5.5 (±4.0) years prior to being enrolled in the study. Anthropometric data, laboratory values and office- and 24-h ambulatory blood pressure monitoring (ABPM) were evaluated. Cardiovascular target organ damage was determined through non-invasive measurements of aortic pulse wave velocity (PWV), carotid intima–media thickness (IMT) and left ventricular mass (LVM).

Results

Elevated PWV or IMT values were detected in 22 and 58% of patients, respectively. Left ventricular hypertrophy was found in as many as 43% of patients. The prevalence of uncontrolled or untreated hypertension was 41%, of which 16% of cases were only detected by ABPM measurements. In the multivariable analysis, higher diastolic blood pressure, everolimus intake and lower estimated glomerular filtration rate were independently associated with high PWV. Higher systolic blood pressure and body mass index were associated with elevated LVM.

Conclusions

Our results showed an alarming burden of cardiovascular subclinical organ damage in children after RT. Hypertension, obesity, immunosuppressive regimen and renal function emerged as independent risk factors of organ damage. Whereas the latter is not modifiable, the results of our study strongly indicate that the management of children after RT should focus on the control of blood pressure and weight.
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Metadaten
Titel
Factors associated with cardiovascular target organ damage in children after renal transplantation
verfasst von
Bianca Borchert-Mörlins
Daniela Thurn
Bernhard M. W. Schmidt
Anja K. Büscher
Jun Oh
Tanja Kier
Elena Bauer
Sabrina Baig
Nele Kanzelmeyer
Markus J. Kemper
Rainer Büscher
Anette Melk
Publikationsdatum
13.08.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Pediatric Nephrology / Ausgabe 11/2017
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-017-3771-8

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