ESPN 53rd Annual Meeting

ESPN 2021


 
Evolution of Cardiovascular Risk Factors in Pediatric Kidney Transplant Recipients
ANNA VÉGH 1 ADRIENN BáRCZI 2 ORSOLYA CSEPREKáL 3 ÉVA KIS 4 GYÖRGY S. REUSZ 1

1- FIRST DEPARTMENT OF PEDIATRICS SEMMELWEIS UNIVERSITY, BUDAPEST, HUNGARY
2- MEDICAL IMAGING CENTRE SEMMELWEIS UNIVERSITY, BUDAPEST, HUNGARY
3- DEPARTMENT OF SURGERY AND TRANSPLANTATION, SEMMELWEIS UNIVERSITY, BUDAPEST, HUNGARY
4- GOTTSEGEN GYÖRGY HUNGARIAN INSTITUTE OF CARDIOLOGY, BUDAPEST, HUNGARY
 
Introduction:

Cardiovascular disease is leading cause of mortality in pediatric kidney transplant recipients. Major cardiovascular events are rare in childhood however, atherosclerosis, increased arterial stiffness and left ventricular hypertrophy may be already present in early stages of kidney disease. Successful kidney transplantation may reduce the overall cardiovascular risk; however, it remains 3-5 times higher than in the general population. The aim of this study was to detect the cardiovascular risk factors in pediatric kidney transplant recipients.

Material and methods:

Fifty-two children and young adults who underwent kidney transplantation before the age of 18 (median [IQR]: 10.79[8.36-23.24] years) were prospectively enrolled into the study. Anthropometric data, laboratory-, office and 24-h ambulatory blood pressure monitoring values and pulse wave velocity (PWV), a marker of arterial stiffness were evaluated at two timepoints (median [IQR]: 2.53[1.03-4.72] years and 9.3[4.03-11.76] years) following transplantation.

Results:

Controlled hypertension (44.2% and 55.7%), hypertriglyceridemia (57.14 % and 38.1%) and anemia (19.2 % and 19.6%) were the most prevalent risk factors at the two timepoints, respectively. At the second follow-up, but not at the first there was a positive correlation between PWV Z score and systolic and diastolic blood pressure (R=0.44, p=0.009; R=0.55 p=0.001). A significant difference in creatinine levels and GFR was also found between those who had their blood pressure controlled, and who had not (mean±SD: GFRcontrolled=74.09±32.44, GFRuncontrolled=49.6±23.13, p=0.025).

Conclusions:

Even though renal transplantation helps reduce the global cardiovascular risk, multiple cardiovascular risk factors were present in our study population at the long-term follow-ups. Our results underline the importance of adequate blood pressure control, since several years after transplantation it may improve outcome measures such as, the graft function and arterial stiffness.

Supported by NKFI-124549 grant.