Hypertension and improved left ventricular mass index in children after renal transplantation

Abstract

This study was conducted to evaluate the changes in BP and LVH after the transplantation and to evaluate the effect of BP changes in LVH. Forty-three pediatric renal transplant patients, with a mean age of 16.99 ± 3.88 years, were enrolled in this study. Twenty-three (53.5%) of the patients were male. Medical records for pretransplantation period (closest to the time of transplantation) and for post-transplantation period (9-12 months after transplantation) were reviewed. All the patients had BP measurements and echocardiographic evaluation in pre- and post-transplantation period. Hypertension was defined as an average systolic and/or diastolic BP that is ≥95th percentile for sex, age, and height. Although the number of patients with hypertension increased from 30 (69.76%) to 35 (81.4%), the number of patients with LVH decreased from 19 (44.1%) to 9 (20.9%) after the transplantation. Although the only significant difference in BP measurements was between the mean Z scores of 24 hour and nighttime mean DBP before and after the transplantation; the mean LVMI, and the prevalence of LVH was significantly lower after the transplantation. There was no significant correlation between the LVMI and the BP measurements. Even though hypertension may persist, there is significant improvement in LVH after renal transplantation.

Longitudinal Changes in Cardiac Structure and Function in Pediatric Kidney Transplant Recipients

“…39,40 Previous studies largely used a crude measure of LVH prevalence as the observed outcome, rather than examining continuous changes in LVM index over time. 40 Studying a continuous measurement is especially important in children, as cutoffs for LVH using LVM index in children with chronic kidney disease have the potential for over- or underestimated LVH prevalence. 41 Our study has extended existing findings by determining that changes seen in the first several years after transplantation, as measured using LVM index scores as a continuous variable over time rather than a discrete cutoff value, are sustained up to 12 years.…”

One‐Year Impact of Kidney Transplantation on Cardiac Abnormalities and Blood Pressure in Hemodialysis Patients

“…Many patients with CKD have LVH, and several studies have reported that LVH was improved after KT (7)(8)(9)(10)(11)(12). Reportedly, the presence of LVH was independently associated with an increased risk for graft dysfunction and future CVD in patients receiving KT (13,14).…”

“…Hypertension is an important risk factor for the development of LVH and is closely linked with body fluid volume (19,20). Although there are several studies on changes in BP after KT, the presence of hypertension and changes in BP were evaluated by various methods (11,12,(21)(22)(23)(24). Some studies reported that BP decreased after KT (11,(21)(22)(23), but others reported that BP rather increased after KT (12,24).…”

“…Although there are several studies on changes in BP after KT, the presence of hypertension and changes in BP were evaluated by various methods (11,12,(21)(22)(23)(24). Some studies reported that BP decreased after KT (11,(21)(22)(23), but others reported that BP rather increased after KT (12,24). As numerous factors such as volume status, cardiac function, use of antihypertensive agents, calcineurin inhibitors, and neurohumoral factors influence on changes in BP (25,26), it is difficult to elucidate the detailed pathophysiological mechanisms of changes in BP after KT.…”

“…Only a few studies have evaluated detailed echocardiographic parameters, and most of the studies which examined cardiac changes reported that LVDd and LVDs decreased and EF and fractional shortening were improved after KT . However, few studies showed a decrease in IVST and PWT after KT.…”