Prevalence of Obesity and Metabolic Changes After Kidney Transplantation: Hungarian Pediatric Cohort Study

Dégi, Arianna; Kis, Éva; Kerti, Andrea; Cseprekál, Orsolya; Szabó, Attila; Reusz, György

doi:10.1016/j.transproceed.2014.05.060

Cited by 15 publications

(9 citation statements)

References 18 publications

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“…87 A study of 41 children examining whether weight gain following renal transplantation, likely due to corticosteroid use, is related to increased pulse wave velocity found no difference in central pulse wave velocity between lean and overweight groups. 88 These studies together indicate that end-stage renal disease leads to arterial stiffening, which can partially be ameliorated by renal transplantation. Improvements may not be detected in the short term following renal transplantation, but better renal function may improve arterial health.…”

Section: Chronic Kidney Disease and Renal Transplantationmentioning

confidence: 95%

Utility of arterial stiffness assessment in children

2018

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Atherosclerotic cardiovascular disease is a leading cause of death and disability worldwide, and the atherosclerotic process begins in childhood. Prevention or containment of risk factors that accelerate atherosclerosis can delay the development of atherosclerotic cardiovascular disease. Although current recommendations are to periodically screen for commonly prevailing risk factors for atherosclerosis in children, a single test that could quantify the cumulative effect of all risk factors on the vasculature, thus assessing arterial health, would be helpful in further stratifying risk. Measurement of pulse wave velocity and assessment of augmentation index - measures of arterial stiffness - are easy-to-use, non-invasive methods of examining arterial health. Various studies have assessed pulse wave velocity and augmentation index in children with commonly occurring conditions including obesity, hypertension, insulin resistance, diabetes mellitus, dyslipidaemia, physical inactivity, chronic kidney disease, CHD and acquired heart diseases, and in children who were born premature or small for gestational age. This article summarises pulse wave velocity and augmentation index assessments and the effects of commonly prevailing chronic conditions on arterial health in children. In addition, currently available reference values for pulse wave velocity and augmentation index in healthy children are included. Further research to establish widely applicable normative values and the effect of lifestyle and pharmacological interventions on arterial health in children is needed.

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Section: Chronic Kidney Disease and Renal Transplantationmentioning

confidence: 95%

Utility of arterial stiffness assessment in children

2018

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“…In our sample, overweight and obesity were highly prevalent (53.8%). Similarly, in a recent cohort study Degi et al found high occurrence of overweight among RTx children and higher BMI was associated with abnormal glycemic control and high BP.…”

Section: Discussionmentioning

confidence: 81%

Cardiometabolic correlates of sleep‐disordered breathing in renal transplant children

Lendvai

Pásti

Szeifert

et al. 2019

Pediatric Transplantation

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Sleep‐disordered breathing, a prevalent condition among adult renal transplant (RTx) recipients, has become an established independent risk factor of MetS, and furthermore, it might contribute to increased CV risk. Despite the proven correlations in adults, there is a lack of evidence for its significance in the pediatric RTx population. In this study, we aimed at assessing the prevalence and the clinical correlates of SDB in RTx children. Data of 13 patients (age [mean ± SD]: 14.2 ± 2.7 years) were analyzed. SDB was evaluated by PSG, as severity score OAHI was applied. Carbohydrate metabolism was characterized by OGTT, whereas CV status was studied by ABPM. Three composite end‐points were calculated as sum of z‐scores: daytime systolic and diastolic BP; nighttime systolic and diastolic BP; and glucose and insulin levels at 120 minutes. Eight patients (61.5%) were diagnosed with SDB of whom five patients (38.5%) had moderate or severe SDB. In linear regression analysis, OAHI during REM was associated with the CV variables (daytime BP P = 0.032, ß = 0.748; nighttime BP P = 0.041, ß = 0.715), and the correlations remained significant after adjustments for BMI. However, we did not confirm a significant association with the metabolic variables. The prevalence of SDB was high, and its severity during REM was a predictor of the BP suggesting that RTx children with SDB might be at risk of developing CV complications, especially HTN similarly to adults.

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“…The incidence of pretransplant obesity is increasing mirroring the rise of obesity in the general pediatric population (25). As in the general population, the development of overweight or obesity after transplantation in children is associated with hypertension and poor glycemic control (26, 27). While these CVD risk factors can more pronounced due to the known side effects of immunosuppressant medications, the effect of obesity on hypertension in the pediatric transplant recipient has been shown to be independent of posttransplant use of steroids (28).…”

Section: Etiology Of Hypertensionmentioning

confidence: 99%

“…In addition, the Young Finn study showed that childhood hypertension was related to higher adult PWV (89). In pediatric kidney transplant recipients, PWV has been shown to be increased compared to control patients matched for age and weight/height (26, 90). Since pediatric kidney transplant recipients have ongoing CKD, strict BP control may help to lower PWV and future cardiovascular risk in this population.…”

Section: Blood Pressure Measurement and Assessment Of Cvd Riskmentioning

confidence: 99%

Hypertension in the Pediatric Kidney Transplant Recipient

Charnaya

Moudgil

2017

Front. Pediatr.

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Hypertension after kidney transplant is a frequent occurrence in pediatric patients. It is a risk factor for graft loss and contributes to the significant burden of cardiovascular disease (CVD) in this population. The etiology of posttransplant hypertension is multifactorial including donor factors, recipient factors, medications, and lifestyle factors similar to those prevalent in the general population. Ambulatory blood pressure monitoring has emerged as the most reliable method for measuring hypertension in pediatric transplant recipients, and many consider it to be essential in the care of these patients. Recent technological advances including measurement of carotid intima-media thickness, pulse wave velocity, and myocardial strain using specked echocardiography and cardiac magnetic resonance imaging have improved our ability to assess CVD burden. Since hypertension remains underrecognized and inadequately treated, an early diagnosis and an appropriate control should be the focus of therapy to help improve patient and graft survival.

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Prevalence of Obesity and Metabolic Changes After Kidney Transplantation: Hungarian Pediatric Cohort Study

Cited by 15 publications

References 18 publications

Utility of arterial stiffness assessment in children

Utility of arterial stiffness assessment in children

Cardiometabolic correlates of sleep‐disordered breathing in renal transplant children

Hypertension in the Pediatric Kidney Transplant Recipient

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