Cardiovascular risk factors in children after kidney transplantation--from short-term to long-term follow-up

Pediatr Transplant. 2014 Feb;18(1):23-8. doi: 10.1111/petr.12174. Epub 2013 Oct 18.

Abstract

Cardiovascular-related mortality is 100-fold higher in pediatric renal transplant recipients than in the age-matched general population. Seventy-seven post-renal transplant children's charts were reviewed for cardiovascular risk factors at two and six months after transplantation (short term) and at two yr after transplantation and the last follow-up visit (mean 7.14 ± 3.5 yr) (long term). Significant reduction was seen in cardiovascular risk factors prevalence from two months after transplantation to last follow-up respectively: Hypertension from 52.1% to 14%, hypercholesterolemia from 48.7% to 33%, hypertriglyceridemia from 50% to 12.5%, anemia from 29.6% to 18.3%, hyperparathyroidism from 32% to 18.3% and hyperglycemia from 11.7% to 10%, and left ventricular hypertrophy from 25.8% at short term to 15%. There was an increase in the prevalence of obesity from 1.5% to 3.9% and of CKD 3-5 from 4.75% to 24%. The need for antihypertensive treatment decreased from 54% to 42%, and the percentage of patients controlled by one medication rose from 26% to 34%, whereas the percentage controlled by 2, 3, and 4 medications decreased from 21.9%, 5.5%, and 1.4% to 6%, 2%, and 0. Children after renal transplantation appear to have high rates of cardiovascular risk factors, mainly on short-term follow-up.

Keywords: cardiac function; kidney transplantation; pediatrics; renal transplantation.

MeSH terms

  • Adolescent
  • Adult
  • Anemia / complications
  • Antihypertensive Agents / therapeutic use
  • Cardiovascular Diseases / complications*
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Humans
  • Hypercholesterolemia / complications
  • Hyperglycemia / complications
  • Hyperparathyroidism / complications
  • Hypertension / complications
  • Hypertriglyceridemia / complications
  • Hypertrophy, Left Ventricular / complications
  • Immunosuppressive Agents / therapeutic use
  • Infant
  • Infant, Newborn
  • Kidney Transplantation*
  • Male
  • Obesity / complications
  • Renal Insufficiency / complications
  • Renal Insufficiency / therapy*
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Young Adult

Substances

  • Antihypertensive Agents
  • Immunosuppressive Agents