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Biliary Atresia Is Associated With Hypertension
Robyn G Matloff1, Rebekah Diamond, Alan Weinberg
1*Division of Pediatric Nephrology, Maria Fareri Children's Hospital of Westchester Medical Center, New York Medical College, Valhalla †Department of Health Evidence and Policy ‡Recanati/Miller Transplantation Institute, New York, NY.
Journal of Pediatric Gastroenterology and Nutrition
|February 5, 2015
Summary
Hypertension is common in children with biliary atresia, regardless of liver transplant status. Pediatric liver transplant recipients experienced declining kidney function post-transplant.
Area of Science:
- Pediatric Nephrology
- Pediatric Gastroenterology
- Transplantation Medicine
Background:
- Improved survival in pediatric liver transplant recipients is linked to increased long-term comorbidities.
- Hypertension and chronic kidney disease (CKD) are significant concerns in this population, potentially leading to target-organ damage.
- The prevalence of hypertension post-pediatric liver transplantation and its association with specific liver failure etiologies like biliary atresia (BA) require further investigation.
Purpose of the Study:
- To investigate the impact of liver transplantation on the prevalence of hypertension and CKD in pediatric patients with biliary atresia (BA).
- To assess the long-term trends of hypertension and renal function in transplanted versus non-transplanted BA patients.
Main Methods:
- A retrospective chart review was conducted on 160 pediatric patients with BA.
- Data on blood pressure and renal function (eGFR) were collected at multiple time points up to 15 years of age.
- Hypertension was defined as systolic blood pressure >95th percentile or antihypertensive medication use; data were stratified by liver transplant status.
Main Results:
- Hypertension was highly prevalent in children with BA from initial visits through age 10, irrespective of transplant status.
- Liver transplant recipients exhibited lower mean estimated glomerular filtration rate (eGFR) compared to non-transplant patients, with a continued decline post-transplant.
- The incidence of chronic kidney disease (CKD) was higher in the liver transplant group, although hypertension was not directly associated with reduced eGFR.
Conclusions:
- Hypertension is a frequent comorbidity in pediatric patients with biliary atresia, independent of liver transplantation.
- Pediatric liver transplant recipients demonstrate significantly impaired and progressively declining renal function.
- While CKD is more common post-transplant, hypertension was not found to be a direct cause of reduced renal function in this cohort.
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