Pediatric Nephrology

, Volume 19, Issue 11, pp 1202–1211

Pathomechanisms and the diagnosis of arterial hypertension in pediatric renal allograft recipients

  • Rainer Büscher
  • Udo Vester
  • A.-M. Wingen
  • Peter F. Hoyer
Review

DOI: 10.1007/s00467-004-1601-2

Cite this article as:
Büscher, R., Vester, U., Wingen, AM. et al. Pediatr Nephrol (2004) 19: 1202. doi:10.1007/s00467-004-1601-2

Abstract

Arterial hypertension is common in pediatric renal allograft recipients. While the causes are multifactorial, including chronic graft rejection, immunosuppressive therapy, and renal vascular disorders, the effect of hypertension on renal allograft function is detrimental. As in adults, if not treated early and aggressively, hypertension may lead to cardiovascular damage and graft failure. Pathophysiological changes in the arteries and kidney after renal transplantation and the impact of receptor regulation have not been studied extensively in children. For identifying children with hypertension following renal transplantation casual blood pressure measurements do not accurately reflect average arterial blood pressure and circadian blood pressure rhythm. Ambulatory 24-h blood pressure monitoring should regularly be applied in transplant patients. The purpose of this review is to analyze pathophysiological aspects of risk factors for arterial hypertension and underline the importance of regular blood pressure monitoring and early therapeutic intervention.

Keywords

Arterial hypertensionRenal transplantationGraft survivalAmbulatory 24-h blood pressure monitoringRenin-angiotensin-aldosterone systemGenetic polymorphism

Copyright information

© IPNA 2004

Authors and Affiliations

  • Rainer Büscher
    • 1
  • Udo Vester
    • 1
  • A.-M. Wingen
    • 1
  • Peter F. Hoyer
    • 1
  1. 1.Department of Pediatric NephrologyUniversity HospitalGermany