Frequency of arterial hypertension, diabetes and dyslipidemia in children after kidney transplants
DOI:
https://doi.org/10.24875/RMIMSS.M20000009Keywords:
Kidney Transplantation, Pediatrics, Hypertension, Dyslipidemias, Diabetes Mellitus, Cardiovascular DiseasesAbstract
Background: Pediatric kidney transplant patients have an increased risk of developing arterial hypertension, dyslipidemia, carbohydrate intolerance and diabetes mellitus, risk factors associated with increased cardiovascular morbidity and mortality.
Objective: This study evaluates the frequency of arterial hypertension, dyslipidemia and alteration in carbohydrate metabolism in a cohort of pediatric kidney transplant patients during 2006-2016 at the Pablo Tobon Uribe Hospital, in Colombia.
Material and methods: Retrospective descriptive study in which descriptive statistics were used. Additionally, a bivariate analysis was performed to compare patients according to the outcome of arterial hypertension, dyslipidemia and alteration in carbohydrate metabolism.
Results: From a total of 48 pediatric kidney transplants in the period studied, complete information was obtained from 43 patients at one year of follow-up. There was a post-transplant frequency of hypertension of 86%, dyslipidemia 48%, carbohydrate intolerance 14% and diabetes of 2%.
Conclusions: In the evaluated cohort a high frequency of arterial hypertension and dyslipidemia was found after kidney transplantation. The development of early diagnosis and treatment guidelines is suggested to reduce the impact of these diseases associated with cardiovascular risk in adult life.
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Becker-Cohen R, Nir A, Rinat C, Feinstein S, Algur N, Farber B, et al. Risk factors for cardiovascular disease in children and young adults after renal transplantation. Clin J Am Soc Nephrol. 2006;1(6):1284-92.
Neale J, Smith AC. Cardiovascular risk factors following renal transplant. World J Transplant. 2015;5(4):183-95.
Prokai A, Fekete A, Kis E, Reusz GS, Sallay P, Korner A, et al. Post-transplant diabetes mellitus in children following renal transplantation. Pediatr Transplant. 2008;12(6):643-9.
Buyan N, Bilge I, Turkmen MA, Bayrakci U, Emre S, Fidan K, et al. Post-transplant glucose status in 61 pediatric renal transplant recipients:preliminary results of five Turkish pediatric nephrology centers. Pediatr Transplant. 2010;14(2):203-11.
Shishido S, Sato H, Asanuma H, Shindo M, Hataya H, Ishikura K, et al. Unexpectedly high prevalence of pretransplant abnormal glucose tolerance in pediatric kidney transplant recipients. Pediatr Transplant. 2006;10(1):67-73.
Koshy SM, Guttmann A, Hebert D, Parkes RK, Logan AG. Incidence and risk factors for cardiovascular events and death in pediatric renal transplant patients:a single center long-term outcome study. Pediatr Transplant. 2009;13(8):1027-33.
Seeman T. Hypertension after renal transplantation. Pediatr Nephrol. 2009;24(5):959-72.
Nagasako SS, Koch-Nogueira PC, Machado PG, Medina-Pestana JO. Arterial hypertension following renal transplantation in children —a short-term study. Pediatr Nephrol. 2003;18(12):1270-4.
National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114(2 Suppl. 4th Report):555-76.
Zachariah JP, Johnson PK. Pediatric lipid management:an earlier approach. Endocrinol Metab Clin North Am. 2014;43(4):981-92.
American Diabetes Association. Executive summary:Standards of medical care in diabetes - 2014. Diabetes Care. 2014;37(Suppl 1):S5-13.
Shivaswamy V, Boerner B, Larsen J. Post-transplant diabetes mellitus:causes, treatment, and impact on outcomes. Endocr Rev. 2016;37(1):37-61.
Organización Mundial de la Salud. Patrones de crecimiento infantil. Ginebra, Suiza;OMS:2010. Disponible en:http://www.who.int/childgrowth/standards/es.
Kidney Disease:Improving Global Outcomes (KDIGO) Transplant Work Group. KDIGO clinical practice guideline for the care of kidney transplant recipients. Am J Transplant. 2009;9(Suppl 3):S1-155.
Silverstein DM, Mitchell M, LeBlanc P, Boudreaux JP. Assessment of risk factors for cardiovascular disease in pediatric renal transplant patients. Pediatr Transplant. 2007;11(7):721-9.
Al-Uzri A, Stablein DM, Cohn RA. Post-transplant diabetes mellitus in pediatric renal transplant recipients:a report of the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS). Transplantation. 2001;72(6):1020-4.
Greenspan LC, Gitelman SE, Leung MA, Glidden DV, Mathias RS. Increased incidence in post-transplant diabetes mellitus in children:a case-control analysis. Pediatr Nephrol. 2002;17(1):1-5.
Baluarte HJ, Gruskin AB, Ingelfinger JR, Stablein D, Tejani A. Analysis of hypertension in children post renal transplantation--a report of the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS). Pediatr Nephrol. 1994;8(5):570-3.
McGlothan KR, Wyatt RJ, Ault BH, Hastings MC, Rogers T, DiSessa T, et al. Predominance of nocturnal hypertension in pediatric renal allograft recipients. Pediatr Transplant. 2006;10(2):558-64.
García-Bello JA, Romo-Del Río EG, Mendoza-Gómez E, Camarena-Arias PA, Santos-Caballero M. Effect of immunosuppressive therapy on cardiovascular risk factor prevalence in kidney-transplanted children:comparative study. Transplant Proc. 2016;48(1):639-42.
Kaidar M, Berant M, Krauze I, Cleper R, Mor E, Bar-Nathan N, et al. Cardiovascular risk factors in children after kidney transplantation —from short-term to long-term follow-up. Pediatr Transplant. 2014;18(1):23-8.
Garro R, Warshaw B, Felner E. New-onset diabetes after kidney transplant in children. Pediatr Nephrol. 2015;30(3):405-16.
Kasiske BL, Snyder JJ, Gilbertson D, Matas AJ. Diabetes mellitus after kidney transplantation in the United States. Am J Transplant. 2003;3(2):178-85.
Grenda R. Effects of steroid avoidance and novel protocols on growth in paediatric renal transplant patients. Pediatr Nephrol. 2010;25(4):747-52.
Sarwal MM, Ettenger RB, Dharnidharka V, Benfield M, Mathias R, Portale A, et al. Complete steroid avoidance is effective and safe in children with renal transplants:a multicenter randomized trial with three-year follow-up. Am J Transplant. 2012;12:2719-29.
Gutiérrez-Dalmau A, Alonso A, Caparrós S, Díaz J, Errasti P, Escuin F, et al. Etiopatogenia y metodología diagnóstica de la hipertensión arterial postrasplante renal. Nefrologia. 2009;29(Supl ext 3):5-10.
Mitsnefes MM, Khoury P, McEnery PT. Body mass index and allograft function in pediatric renal transplantation. Pediatr Nephrol. 2002;17(7):535-9.
Gordjani N, Offner G, Hoyer PF, Brodehl J. Hypertension after renal transplantation in patients treated with cyclosporin and azathioprine. Arch Dis Child. 1990;65(3):275-9.
Trompeter R, Filler G, Webb NJ, Watson AR, Milford DV, Tyden G, et al. Randomized trial of tacrolimus versus cyclosporin microemulsion in renal transplantation. Pediatr Nephrol. 2002;17(3):141-9.
Sarwal MM, Vidhun JR, Alexander SR, Satterwhite T, Millan M, Salvatierra O Jr. Continued superior outcomes with modification and lengthened follow-up of a steroid-avoidance pilot with extended daclizumab induction in pediatric renal transplantation. Transplantation. 2003;76(9):1331-9.
Riella LV, Gabardi S, Chandraker A. Dyslipidemia and its therapeutic challenges in renal transplantation. Am J Transplant. 2012;12(8):1975-82.
Bonthuis M, van Stralen KJ, Jager KJ, Baiko S, Jahnukainen T, Laube GF, et al. Dyslipidaemia in children on renal replacement therapy. Nephrol Dial Transplant. 2014;29(3):594-603.
Silverstein DM, Palmer J, Polinsky MS, Braas C, Conley SB, Baluarte HJ. Risk factors for hyperlipidemia in long-term pediatric renal transplant recipients. Pediatr Nephrol. 2000;14(2):105-10.
Tse KC, Lam MF, Yip PS, Li FK, Lai KN, Chan TM. A long-term study on hyperlipidemia in stable renal transplant recipients. Clin Transplant. 2004;18(3):274-80.
Ekberg H, Tedesco-Silva H, Demirbas A, Vitko S, Nashan B, Gurkan A, et al. Reduced exposure to calcineurin inhibitors in renal transplantation. N Engl J Med. 2007;357(25):2562-75.
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