Background. Hypertension in patients after renal transplantation (RTx) is associated with impaired graft functions
and graft survival. Control of hypertension in children after RTx is low – only 20–50 % of children have well
controlled hypertension. The aim of this interventional study is to improve blood pressure control and to investigate
whether the improved control will improve the graft survival.
Methods and Results. 36 children after RTx (mean age 13.9±4.4 years, time after RTx 2.7±2.4) fulfilled the inclusion
criteria. Ambulatory blood pressure monitoring (ABPM) and graft function were examined. In children with
uncontrolled hypertension, the dose and number of antihypertensive drugs were increased to reach BP <95th centile.
ABPM was repeated after 12 months. After 12 months day-time and night-time BP dropped non-significantly,
however prevalence of uncontrolled hypertension improved significantly from 42 % to 34 % (p<0.05). Number of
antihypertensive drugs increased from 2.1±0.9 to 2.4±0.8 drugs per patient (p<0.05), namely that of ACE-inhibitors
(from 19% to 27%, p<0.05). Graft function decreased by 3.6 ml/min/1.73m2/year (p<0.05).
Conclusions. This 12months interventional trial demonstrated that control of hypertension in children after RTx can
be improved by increasing number of prescribed antihypertensive drugs. The decline of graft function was lower
comparing with previous trials.
hypertension, renal transplantation, children, angiotensin-converting enzyme inhibitors, graft function,