Abstract
The files of 334 consecutive cadaver kidney (CK) and of 27 living related (LR) transplantations (T) in children and adolescents performed from 1973 to 1984 have been reviewed. Following cadaver transplantation, 52 patients (15%) never had hypertension (HT), 41 patients (12%) had only initial HT up to 6 months after transplantation and 18 other patients (5%) exhibited transient HT episodes while on high-dose steroid therapy. Finally, 209 patients (62%) had HT for periods longer than 6 months and 16 patients (5%) until death or graft failure within the first 3 months. Chronic graft rejection was the major cause of HT, but other factors either isolated or in association were also present. Renal artery stenosis (RAS) was diagnosed in 43 cases (13%) 2–17 months post-transplantation; 10 of these were operated upon (5 successfully) and 9 underwent transluminal angioplasty with a single success. Nine cases of RAS resolved spontaneously. HT was attributed to the host kidney in 10 cases (3%) and to recurrence of primary renal disease in 9 (3%). HT observed after CKT was sometimes severe and difficult to control. Acute complications from HT were recorded in 35 cases, with 6 deaths and 2 severe neurological sequelae. Among 25 LRT, 11 cases (40%) had no HT 13 (48%) had HT for longer than 6 months. In this group, no case of RAS was observed and only one complication (without sequelae) was noted. In conclusion, HT is a frequent and sometimes severe complication post-transplantation in children and adolescents.
Similar content being viewed by others
References
Ingelfinger JR (1984) Hypertension in children with ESRD In Fine RN, Gruskin Ab (eds) End stage renal disease in children. Saunders, Philadelphia, pp 340–358
Tejani A (1983) Post transplant hypertension and hypertensive encephalopathy in renal allograft recipients. Nephron 34: 73–78
Broyer M, Guest G, Gagnadoux MF, Beurton D (1985) Résultats de 310 greffes de rein de cadavre chez l'enfant. Arch Fr Pédiatr 42: 237–243
Broyer M, Andre JL (1980) Nouveaux regards sur l'hypertension artérielle de l'enfant. Arch Fr Pédiatr 37: 429–430
Rao STK, Gupta SK, Butt KMH, Kountz S, Friedman EA (1978) Relationship of renal transplantation to hypertension in end stage renal failure. Arch Intern Med 138: 1236–1241
Bachy C, Van Ypersele de Strihou C, Alexandre GPK, Troch R (1976) Hypertension after renal transplantation. Proc Eur Diol Transplant Assoc 12: 461–470
Whelton PK, Russell RP, Harrington DP, Williams GM, Walker WG (1979) Hypertension following renal transplantation: causative factors and therapeutic implications. J Am Med Assoc 241: 1188–1131
Caldicott WJH, Ingelfinger JR (1981) The effect of increasing renal mass on cardiovascular function in immature dogs. Pediatr Res 6: 935–939
Curtis JJ, Gall JH, Kotchen TA, Lucas B, McRoberts JW, Luke RG (1976) Prevalence of hypertension in a renal transplant population on alternate day steroid therapy. Clin Nephrol 5: 123–127
Ingelfinger JR (1981) Hypertension in children with kidney transplants In: Gruskin AB, Norman ME (eds) Pediatric nephrology. Proceedings of the 5th international pediatric nephrology symposium. Martinus Nijoff, Boston, pp 376–382
Vegter A, Bosch E, Westra D, Linschoten H (1978) Spontaneous reversible renal artery stenosis after renal allotransplantation. Br Med J 2: 1028–1029
Grunfeld JP, Kleinknecht D, Moreau JF, Kamoun P, Sabto J, Garcia Tores R, Osorio M, Kreis H (1975) Permanent hypertension after renal transplantation in man. Clin Sci Mol Med 48: 391–403
Mc Hugh MI, Tanboga H, Marcen R, Liano F, Robson V, Wilkinson R (1980) Hypertension following renal transplantation: the role of host's kidneys. Q J Med 49: 395–403
Malekzadeh MH, Brennan LP, Payne VC, Fine RN (1975) Hypertension after renal transplantation in children. J Pediatr 86: 370–375
Najarian MS, Simmons RL, Tallent MG (1971) Renal transplantation in infants and children. Ann Surg 174: 583–59
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Broyer, M., Guest, G., Gagnadoux, MF. et al. Hypertension following renal transplantation in children. Pediatr Nephrol 1, 16–21 (1987). https://doi.org/10.1007/BF00866879
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00866879