Risk factors for cardiovascular disease in pediatric renal transplant recipients

Silverstein, Douglas M.

doi:10.1111/j.1399-3046.2004.00105.x

Cited by 27 publications

(19 citation statements)

References 75 publications

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“…The incidence of NODAT is increasing in pediatric renal transplant recipients, although it remains less prevalent than in the adult population [2]. NODAT adds to the burden of cardiovascular disease observed in children following kidney transplantation [3, 4]. A deeper understanding of this co-morbid disease is needed in order to inform strategies to aid its prevention and improve clinical management.…”

Section: Introductionmentioning

confidence: 99%

Hypomagnesemia and increased risk of new-onset diabetes mellitus after transplantation in pediatric renal transplant recipients

et al. 2016

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BackgroundNew-onset diabetes after transplantation (NODAT) is a significant co-morbidity following kidney transplantation. Lower post-transplant serum magnesium levels have been found to be an independent risk factor for NODAT in adult kidney transplant recipients.MethodsWe undertook a retrospective analysis of risk factors for NODAT in pediatric renal transplant recipients at our institution with the aim of determining if hypomagnesemia confers a significant risk of developing NODAT in this patient population.ResultsA total of 173 children with a median age at transplantation of 7.0 (range 1.3–17.5) years were included. Hypomagnesemia was found to be a significant independent risk factor for NODAT (p = 0.01). High trough tacrolimus levels were also independently associated with NODAT (p < 0.001). There was no significant association between NODAT and body mass index at the time of transplantation, monthly cumulative steroid dose or post-transplant cytomegalovirus viremia (p = 0.9, 0.6 and 0.7, respectively).ConclusionsThis study identifies hypomagnesemia as a significant independent risk factor for the development of NODAT in pediatric renal transplant recipients. Given the clear association between hypomagnesemia and NODAT in both adults and children following renal transplantation, further studies are merited to clarify the etiology of this association and to examine the effect of magnesium supplementation on NODAT.

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Section: Introductionmentioning

confidence: 99%

Hypomagnesemia and increased risk of new-onset diabetes mellitus after transplantation in pediatric renal transplant recipients

et al. 2016

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“…Abnormal lipid metabolism is common in patients with ESRD and adult KT recipients, and the degree of dyslipidemia has been shown to be directly proportional to the decrease in GFR . In adult KT recipients, disturbances in lipoprotein metabolism accelerate atherosclerosis and have a considerable adverse effect on KT outcomes with almost 50% of transplant recipients demonstrating dyslipidemia early after KT, which seems to be arbitrated by high‐dose immunosuppression with steroids and CNIs . However, its impact in pediatric KT recipients is less clear.…”

Section: Discussionmentioning

confidence: 95%

Incidence and magnitude of post‐transplant cardiovascular disease after pediatric kidney transplantation: Risk factor analysis of 1058 pediatric kidney transplants at the university of Minnesota

Serrano

Bangdiwala

Vock

et al. 2018

Pediatric Transplantation

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“…There is much concern about long‐term cardiovascular morbidity in children with RTx (17) and obesity does contribute to many of the known risk factors like hypertension, hyperlipidemia and diabetes mellitus (7). In addition, obesity impairs graft survival and function in adult (5) and pediatric renal graft recipients (4).…”

Section: Discussionmentioning

confidence: 99%

Development of growth and body mass index after pediatric renal transplantation

Vester

Schaefer

Kranz

et al. 2005

Pediatric Transplantation

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Suboptimal final height and marked weight gain after renal transplantation (RTx) are common and may result in obesity. Steroid free immunosuppression has been advocated to improve growth and limit weight gain. We evaluated retrospectively the evolution of growth and body mass index (BMI) after renal transplantation to study risk factors for weight gain under steroid based treatment. Sixty-four pediatric patients (age 9.9 +/- 5.0 yr) were included in the study. To allow comparison between different age groups, standard deviation scores (SDS) for height and BMI for height age were calculated at time of transplantation and 3, 6, 9, 12, 24, 36, 48 and 60 months later. Induction immunosuppression consisted of basiliximab, cyclosporine and prednisone. Growth retardation at time of RTx was obvious with a SDS for height of -2.20 +/- 1.34. Height during the first year improved to an SDS of -2.0 +/- 1.27 (p < 0.01) but did further not increase in year 2 and 3. More than 40% of all patients remained 2 SDS below normal mean. SDS BMI for height age at transplantation was -0.19 +/- 0.98 and increased significantly during the first 3 months after transplantation to +0.64 +/- 1.07 (p < 0.01). Thereafter, BMI remained stable but did not decline to pretransplant values. A SDS BMI for height age of more than 2 SDS was observed in 2, 6, 9 and 11% of children at RTx and 1, 2 and 3 yr later respectively. BMI gain over 3 yr was significantly enhanced in children whose parents (especially the mother) were overweight. No influence of gender, BMI at RTx, dialysis modality prior to RTx or rejection episodes could be detected. We conclude that after RTx children exhibit some improvement in growth but height remains suboptimal. The BMI does increase significantly during the first months after RTx and does not return to baseline values under steroid-based immunosuppression. Obesity (>2 SDS above normal) does not occur more often than in the normal population. The most predictive parameter of inappropriate weight gain during 3 yr is the BMI of the mother. We would speculate that steroids may play a major role in weight gain in the early phase after RTx. However, genetic or environmental factors predict the long-term weight development.

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Risk factors for cardiovascular disease in pediatric renal transplant recipients

Cited by 27 publications

References 75 publications

Hypomagnesemia and increased risk of new-onset diabetes mellitus after transplantation in pediatric renal transplant recipients

Hypomagnesemia and increased risk of new-onset diabetes mellitus after transplantation in pediatric renal transplant recipients

Incidence and magnitude of post‐transplant cardiovascular disease after pediatric kidney transplantation: Risk factor analysis of 1058 pediatric kidney transplants at the university of Minnesota

Development of growth and body mass index after pediatric renal transplantation

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