Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-13T02:52:13.976Z Has data issue: false hasContentIssue false
  • English
  • Français

Is low birth weight an additional risk factor for hypertension in paediatric patients after kidney transplantation?

Published online by Cambridge University Press:  16 August 2019

Larissa Badim Santos ,
Luana Meireles Borges ,
Livia Victorino Souza ,
Claudia Rosso Felipe ,
José Osmar Medina-Pestana  and
Maria do Carmo Franco Open the ORCID record for Maria do Carmo Franco [Opens in a new window]
Larissa Badim Santos
Affiliation:
Department of Medicine, Nephrology Division, School of Medicine, Federal University of São Paulo, São Paulo, Brazil
Luana Meireles Borges
Affiliation:
Department of Medicine, Nephrology Division, School of Medicine, Federal University of São Paulo, São Paulo, Brazil
Livia Victorino Souza
Affiliation:
Department of Medicine, Nephrology Division, School of Medicine, Federal University of São Paulo, São Paulo, Brazil
Claudia Rosso Felipe
Affiliation:
Department of Medicine, Nephrology Division, School of Medicine, Federal University of São Paulo, São Paulo, Brazil
José Osmar Medina-Pestana
Affiliation:
Department of Medicine, Nephrology Division, School of Medicine, Federal University of São Paulo, São Paulo, Brazil
Maria do Carmo Franco*
Affiliation:
Department of Medicine, Nephrology Division, School of Medicine, Federal University of São Paulo, São Paulo, Brazil
*
Address for correspondence: Maria do Carmo Franco, Division of Nephrology, School of Medicine, Laboratory of Translational Research in Vascular and Molecular Physiology, Federal University of São Paulo, Rua Botucatu, 862-São Paulo, SP, Brazil. Email: maria.franco@unifesp.br
Get access Rights & Permissions [Opens in a new window]

Abstract

Hypertension (HTN) remains a common complication after kidney transplantation among paediatric patients. Although low birth weight (LBW) has been implicated as an important risk factor for cardiovascular diseases, its effect on transplantation patients has not yet been addressed. It is essential to determine whether children with LBW who undergo transplantation are more likely to develop post-transplantation HTN. For this study, the medical records of 96 kidney recipients were retrospectively examined. A total of 83 patients fulfilled the inclusion criteria. Overall, post-transplantation HTN was observed in 54% of the recipients. Multivariate logistic regression revealed that time from transplantation >14 months (odds ratio (OR) 3.6; 95% confidence interval (CI) 1.31–10.06; P = 0.013), current CKD (OR 2.6; 95% CI 1.01–7.20; P = 0.045), presence of LBW (OR 3.6; 95% CI 1.04–12.32; P = 0.044) and current overweight/obesity (OR 3.7; 95% CI 1.02–13.91; P = 0.047) were associated with post-transplantation HTN. In conclusion, our data provide evidence for the first time that LBW is a significant predictive factor in the development of post-transplantation HTN. This finding has important clinical implications as it serves to alert clinicians about this additional risk factor in paediatric patients undergoing kidney transplant.

Keywords

Low birth weightpost-transplantation hypertensionkidney transplantchildren
Type
Brief Report
Information
Journal of Developmental Origins of Health and Disease , Volume 11 , Issue 1 , February 2020 , pp. 3 - 6
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

McDonald, SP, Craig, JC. Long-term survival of children with end-stage renal disease. N Engl J Med. 2004; 350, 2654–2662.CrossRefGoogle ScholarPubMed
Wigger, M, Drückler, E, Muscheites, J, Stolpe, HJ. Course of glomerular filtration rate after renal transplantation and the influence of hypertension. Clin Nephrol. 2001; 56, S30–S34.Google ScholarPubMed
Seeman, T. Hypertension after renal transplantation. Pediatr Nephrol. 2009; 24, 959–972.CrossRefGoogle ScholarPubMed
Buscher, R, Vester, U, Wingen, AM, Hoyer, PF. Pathomecanisms and the diagnosis of arterial hypertension in pediatric renal allograft recipients. Pediatr Nephrol. 2004; 19, 1202–1211.CrossRefGoogle Scholar
Mitsnefes, MM, Khoury, PR, McEnery, PT. Early posttransplantation hypertension and poor long-term renal allograft survival in pediatric patients. J Pediatr. 2003; 143, 98–103.CrossRefGoogle ScholarPubMed
Charnaya, O, Moudgil, A. Hypertension in the pediatric kidney transplant recipient. Front Pediatr. 2017; 5, 86. doi: 10.3389/fped.2017.00086.CrossRefGoogle ScholarPubMed
Barker, DJ. Early growth and cardiovascular disease. Arch Dis Child. 1999; 80, 305–307.CrossRefGoogle ScholarPubMed
Eriksson, M, Wallander, MA, Krakau, I, Wedel, H, Svardsudd, K. Birth weight and cardiovascular risk factors in a cohort followed until 80 years of age: the study of men born in 1913. J Intern Med. 2004; 255, 236–246.CrossRefGoogle Scholar
Franco, MC, Christofalo, DM, Sawaya, AL, Ajzen, SA, Sesso, R. Effects of low birth weight in 8- to 13-year-old children: implications in endothelial function and uric acid levels. Hypertension. 2006; 48, 45–50.CrossRefGoogle ScholarPubMed
Franco, MC, Nishida, SK, Sesso, R. GFR estimated from cystatin C versus creatinine in children born small for gestational age. Am J Kidney Dis. 2008; 51, 925–932.CrossRefGoogle ScholarPubMed
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, 1–22.Google Scholar
Schwartz, GJ, Work, DF. Measurement and estimation of GFR in children and adolescents. J Am Soc Nephrol. 2009; 4, 1832–1843.CrossRefGoogle ScholarPubMed
National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002; 39, S14–S266.Google Scholar
Weir, MR, Burgess, ED, Cooper, JE, et al. Assessment and management of hypertension in transplant patients. J Am Soc Nephrol. 2015; 26, 1248–1260.CrossRefGoogle ScholarPubMed
Silverstein, DM, Mitchell, M, LeBlanc, P, Boudreaux, JP. Assessment of risk factors for cardiovasuclar disease in pediatric renal transplant patients. Pediatr Transplant. 2007; 11, 721–729.CrossRefGoogle ScholarPubMed
Nagasako, SS, Nogueira, PCK, Machado, PGP, Pestana, JOM. Arterial hypertension following renal transplantation in children–a short term study. Pediatr Nephrol. 2003; 18, 1270–1274.CrossRefGoogle ScholarPubMed
Nagasako, SS, Nogueira, PC, Machado, PG, Pestana, JO. Risk factors for hypertension 3 years after renal transplantation in children. Pediatr Nephrol. 2007; 22, 1363–1368.CrossRefGoogle ScholarPubMed
Carvalho, MFC, Soares, V. Factors associated with arterial hypertension after renal transplantation. Transplant Proc. 1998; 30, 2872–2873. CrossRefGoogle ScholarPubMed
Franco, MC, Higa, EM, D’Almeida, V, et al. Homocysteine and nitric oxide are related to blood pressure and vascular function in small-for-gestational-age children. Hypertension. 2007; 50, 396–402.CrossRefGoogle ScholarPubMed
Luyckx, VA, Brenner, BM. The clinical importance of nephron mass. J Am Soc Nephrol. 2010; 21, 898–910.CrossRefGoogle ScholarPubMed