Ambulatory Blood Pressure Control in Children and Young Adults After Kidney Transplantation
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Published on: June 6, 2025
Gilad Hamdani1, Edward J Nehus1, Coral D Hanevold2
1Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Insights
Ambulatory blood pressure monitoring (ABPM) in young kidney transplant recipients shows a decrease in hypertension prevalence over time, primarily due to better hypertension control. This trend was most notable in patients under 18 years old.
Area of Science:
- Nephrology
- Pediatric Nephrology
- Cardiology
Background:
- Ambulatory blood pressure monitoring (ABPM) is crucial for assessing blood pressure (BP) in kidney transplant recipients.
- Longitudinal data on ambulatory BP (ABP) trends in pediatric and young adult kidney transplant recipients are scarce.
Purpose of the Study:
- To evaluate longitudinal ambulatory BP trends in pediatric and young adult kidney transplant recipients.
- To identify associations between ABP status and patient/clinical characteristics over time.
Main Methods:
- Retrospective review of a large cohort of pediatric and young adult kidney transplant recipients.
- Analysis of baseline and follow-up ABPM data (median follow-up: 2.3 years).
Main Results:
- Hypertension treatment increased (72% to 80%), and ambulatory hypertension prevalence decreased (54% to 36%) at follow-up.
- Controlled hypertension increased significantly (26% to 45%), particularly in patients younger than 18 at baseline.
- High baseline mean 24-hour systolic BP was independently linked to persistent hypertension.
Conclusions:
- Ambulatory hypertension prevalence declines in young kidney transplant recipients over time.
- Improved hypertension management, leading to increased controlled hypertension rates, drives this decrease.
Background:
Ambulatory blood pressure (BP) monitoring (ABPM) is the preferred method to characterize BP status, and its use in kidney transplant recipients is increasing. Data on longitudinal ambulatory BP (ABP) trends in pediatric and young adult kidney transplant recipients are limited.
Methods:
Retrospective review of a large cohort of children and young adults following kidney transplantation and evaluation of their ABP status over time and its associations with any patient and clinical characteristics.
Results:
Two hundred and two patients had baseline ABPM available for analysis, and 123 of them had a follow up (median time 2.3 years) ABPM. At the time of follow up, more patients were treated for hypertension (80% vs. 72%, P = 0.02), and less patients had ambulatory hypertension (36% vs. 54%, P = 0.005), uncontrolled or untreated, compared with baseline, with 45% of all patients classified as having controlled hypertension (compared to 26% at baseline, P = 0.002). Prevalence of ambulatory hypertension decreased only in patients who were less than 18 years old at baseline. High baseline mean 24-hour systolic BP was independently associated with persistent hypertension.
Conclusions:
In young kidney transplant recipients followed by ABPM, the prevalence of ambulatory hypertension decreases over time, mainly due to the increased number of patients with controlled hypertension.
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