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Updated: Jul 10, 2026
Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension
Published on: June 6, 2025
Hypertension after renal transplantation
1Department of Pediatrics and Transplantation Center University, University Hospital Motol, Charles University Prague, Second School of Medicine, Prague, Czech Republic. tomas.seeman@lfmotol.cuni.cz
Insights
Post-transplant hypertension affects 60-90% of children and is a major risk for graft loss. Improving antihypertensive therapy is crucial for better outcomes in pediatric kidney transplant recipients.
Area of Science:
- Pediatric Nephrology
- Transplantation Medicine
- Cardiovascular Health
Background:
- Hypertension is a frequent and serious complication following renal transplantation in children.
- It significantly increases the risk of graft loss, morbidity, and mortality.
- Common causes include native kidney issues, immunosuppressive drugs, renal artery stenosis, and chronic allograft nephropathy.
Purpose of the Study:
- To highlight the prevalence and impact of hypertension in pediatric kidney transplant recipients.
- To emphasize the importance of accurate blood pressure monitoring using ambulatory BP monitoring (ABPM).
- To discuss current treatment challenges and potential improvements in managing post-transplant hypertension.
Main Methods:
- Review of current literature on post-transplant hypertension in children.
- Emphasis on diagnostic methods including casual BP (CBP) and ABPM.
- Analysis of treatment strategies and their effectiveness.
Main Results:
- Prevalence of post-transplant hypertension ranges from 60% to 90%.
- Left ventricular hypertrophy affects 50-80% of hypertensive pediatric transplant patients.
- Only 20-50% of treated children achieve normal blood pressure, indicating suboptimal control.
Conclusions:
- Effective management of hypertension is critical for long-term graft and patient survival in pediatric kidney transplant recipients.
- Improving antihypertensive therapy, potentially by increasing the number of drugs used, is essential.
- Aggressive blood pressure control holds significant potential to improve outcomes.
Abstract:
Hypertension is a common and serious complication after renal transplantation. It is an important risk factor for graft loss and morbidity and mortality of transplanted children. The etiology of posttransplant hypertension is multifactorial: native kidneys, immunosuppressive therapy, renal-graft artery stenosis, and chronic allograft nephropathy are the most common causes. Blood pressure (BP) in transplanted children should be measured not only by casual BP (CBP) measurement but also regularly by ambulatory BP monitoring (ABPM). The prevalence of posttransplant hypertension ranges between 60% and 90% depending on the method of BP measurement and definition. Left ventricular hypertrophy is a frequent type of end-organ damage in hypertensive children after transplantation (50-80%). All classes of antihypertensive drugs can be used in the treatment of posttransplant hypertension. Hypertension control in transplanted children is poor; only 20-50% of treated children reach normal BP. The reason for this poor control seems to be inadequate antihypertensive therapy, which can be improved by increasing the number of antihypertensive drugs. Improved hypertension control leads to improved long-term graft and patient survival in adults. In children, there is a great potential for antihypertensive treatment that could also result in improved graft and patient survival.
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