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- Title
Epidemiology and management of hypertension in paediatric and young adult kidney transplant recipients in The Netherlands.
- Authors
Dobrowolski, Linn C.; van Huis, Maike; van der Lee, Johanna H.; Sengers, Hessel Peters; Liliën, Marc R.; Cransberg, Karlien; Cornelissen, Marlies; Bouts, Antonia H.; de Fijter, Johan W.; Berger, Stefan P.; van Zuilen, Arjan; Nurmohamed, Shaikh A.; Betjes, Michiel H. G.; Hilbrands, Luuk; Hoitsma, Andries J.; Bemelman, Frederike J.; Krediet, Paul; Groothoff, Jaap W.
- Abstract
Introduction. Hypertension in kidney transplant recipients (KTRs) is a risk factor for cardiovascular mortality and graft loss. Data on the prevalence of hypertension and uncontrolled hypertension (uHT) in paediatric and young adult KTRs are scarce. Also, it is unknown whether 'transition' (the transfer from paediatric to adult care) influences control of hypertension. We assessed the prevalence of hypertension and uHT among Dutch paediatric and young adult KTRs and analysed the effects of transition. Additionally, we made an inventory of variations in treatment policies in Dutch transplant centres. Methods. Cross-sectional and longitudinal national data from living KTRs =30 years of age (=1-year post-transplant, eGFR >20 mL/min) were extracted from the 'RICH Q' database, which comprises information about all Dutch KTRs <19 years of age, and the Netherlands Organ Transplant Registry database for adult KTRs (=18-30 years of age). We used both upper-limit blood pressure (BP) thresholds for treatment according to Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. uHT was defined as a BP above the threshold. A questionnaire on treatment policies was sent to paediatric and adult nephrologists at eight Dutch transplant centres. Results. Hypertension and uHT were more prevalent in young adult KTRs (86.4 and 75.8%) than in paediatric KTRs (62.7 and 38.3%) according to the KDIGO definition. Time after transplantation was comparable between these groups. Longitudinal analysis showed no evidence of effect of transition on systolic BP or prevalence of uHT. Policies vary considerably between and within centres on the definition of hypertension, BP measurement and antihypertensive treatment. Conclusion. Average BP in KTRs increases continuously with age between 6 and 30 years. Young adult KTRs have significantly more uHT than paediatric KTRs according to KDIGO guidelines. Transition does not influence the prevalence of uHT.
- Subjects
NETHERLANDS; HYPERTENSION in children; EPIDEMIOLOGY; KIDNEY transplantation; HEALTH of young adults; THERAPEUTICS
- Publication
Nephrology Dialysis Transplantation, 2016, Vol 31, Issue 11, p1947
- ISSN
0931-0509
- Publication type
Article
- DOI
10.1093/ndt/gfw225