Short‐term pediatric renal transplant survival: Blood pressure and allograft function

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Abstract
Hypertension is prevalent after renal transplantation (Tx) and associated with graft failure in children and adults. However, the effect of blood pressure (BP) on short‐term renal allograft function is uncertain. We assessed the associations among BP pretransplant, and 3 months and 1 yr post‐transplant, and 1‐yr post‐transplant measured glomerular filtration rate (mGFR) in 61 children with a functioning graft. The GFR was determined using a single intravenous (i.v.) injection of Optiray 350®. Data were collected between January 1994 and January 2000. The mean mGFR 1 yr after renal transplant was 63.6 ± 19.9 mL/min/1.73 m2 in 26 live donor recipients and 50.8 ± 23.3 mL/min/1.73 m2 in 35 cadaveric donors (p = 0.029). Correlation analysis showed significant negative associations of 1‐yr mGFR with systolic blood pressure (SBP) and diastolic blood pressure (DBP) 3 months after renal Tx (r = − 0.58, p < 0.0001 and r = − 0.50, p < 0.0001, respectively), and with SBP (r = − 0.37, p = 0.003) and DBP (r = − 0.32, p = 0.01) 1 yr after renal Tx. Multi‐variate regression analysis showed that the SBP 3 months after Tx (p < 0.001), number of acute rejections (p = 0.002), donor age (p = 0.02), and cold ischemia time (p = 0.03) were independent predictors for the 1‐yr mGFR. These results indicate that a higher SBP in the first few months post‐renal Tx is associated with decreased renal allograft function in children 1 yr post‐Tx.