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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
PubMed

Insights

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.
Abstract

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