Epidemiology and management of hypertension in paediatric and young adult kidney transplant recipients in The Netherlands: Nephrology Dialysis Transplantation

L. C. Dobrowolski; A.M. van Huis; J. H. van der Lee; H. P. Sengers; M.R. Lilien; K. Cransberg; M. Cornelissen; A.H. Bouts; Johan W. de Fijter; S.P. Berger; Arjan van Zuilen; S. A. Nurmohamed; M.G.H. Betjes; Luuk Hilbrands; A.J. Hoitsma; F.J. Bemelman; C. T. P. Krediet; J. W. Groothoff

doi:https://doi.org/10.1093/ndt/gfw225

Epidemiology and management of hypertension in paediatric and young adult kidney transplant recipients in The Netherlands: Nephrology Dialysis Transplantation

L. C. Dobrowolski, A.M. van Huis, J. H. van der Lee, H. P. Sengers, M.R. Lilien, K. Cransberg, M. Cornelissen, A.H. Bouts, Johan W. de Fijter, S.P. Berger, Arjan van Zuilen, S. A. Nurmohamed, M.G.H. Betjes, Luuk Hilbrands, A.J. Hoitsma, F.J. Bemelman, C. T. P. Krediet, J. W. Groothoff

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Abstract

Hypertension in kidney transplant recipients (KTRs) is a risk factor for cardiovascular mortality and graft loss. Data on the prevalence of hypertension and uncontrolled hypertension (uHT) in paediatric and young adult KTRs are scarce. Also, it is unknown whether 'transition' (the transfer from paediatric to adult care) influences control of hypertension. We assessed the prevalence of hypertension and uHT among Dutch paediatric and young adult KTRs and analysed the effects of transition. Additionally, we made an inventory of variations in treatment policies in Dutch transplant centres. Cross-sectional and longitudinal national data from living KTRs a parts per thousand currency sign30 years of age (a parts per thousand yen1-year post-transplant, eGFR > 20 mL/min) were extracted from the 'RICH Q' database, which comprises information about all Dutch KTRs <19 years of age, and the Netherlands Organ Transplant Registry database for adult KTRs (a parts per thousand yen18-30 years of age). We used both upper-limit blood pressure (BP) thresholds for treatment according to Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. uHT was defined as a BP above the threshold. A questionnaire on treatment policies was sent to paediatric and adult nephrologists at eight Dutch transplant centres. Hypertension and uHT were more prevalent in young adult KTRs (86.4 and 75.8%) than in paediatric KTRs (62.7 and 38.3%) according to the KDIGO definition. Time after transplantation was comparable between these groups. Longitudinal analysis showed no evidence of effect of transition on systolic BP or prevalence of uHT. Policies vary considerably between and within centres on the definition of hypertension, BP measurement and antihypertensive treatment. Average BP in KTRs increases continuously with age between 6 and 30 years. Young adult KTRs have significantly more uHT than paediatric KTRs according to KDIGO guidelines. Transition does not influence the prevalence of uHT.

Original language	English
Pages (from-to)	1947-1956
Number of pages	10
Journal	Nephrology, dialysis, transplantation
Volume	31
DOIs	https://doi.org/10.1093/ndt/gfw225
Publication status	Published - 2016

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https://doi.org/10.1093/ndt/gfw225

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Dobrowolski, L. C., van Huis, A. M., van der Lee, J. H., Sengers, H. P., Lilien, M. R., Cransberg, K., Cornelissen, M., Bouts, A. H., de Fijter, J. W., Berger, S. P., van Zuilen, A., Nurmohamed, S. A., Betjes, M. G. H., Hilbrands, L., Hoitsma, A. J., Bemelman, F. J., Krediet, C. T. P., & Groothoff, J. W. (2016). Epidemiology and management of hypertension in paediatric and young adult kidney transplant recipients in The Netherlands: Nephrology Dialysis Transplantation. Nephrology, dialysis, transplantation, 31, 1947-1956. https://doi.org/10.1093/ndt/gfw225

@article{eee6beff6fcd4fd39294164738671e42,

title = "Epidemiology and management of hypertension in paediatric and young adult kidney transplant recipients in The Netherlands: Nephrology Dialysis Transplantation",

abstract = "Hypertension in kidney transplant recipients (KTRs) is a risk factor for cardiovascular mortality and graft loss. Data on the prevalence of hypertension and uncontrolled hypertension (uHT) in paediatric and young adult KTRs are scarce. Also, it is unknown whether 'transition' (the transfer from paediatric to adult care) influences control of hypertension. We assessed the prevalence of hypertension and uHT among Dutch paediatric and young adult KTRs and analysed the effects of transition. Additionally, we made an inventory of variations in treatment policies in Dutch transplant centres. Cross-sectional and longitudinal national data from living KTRs a parts per thousand currency sign30 years of age (a parts per thousand yen1-year post-transplant, eGFR > 20 mL/min) were extracted from the 'RICH Q' database, which comprises information about all Dutch KTRs <19 years of age, and the Netherlands Organ Transplant Registry database for adult KTRs (a parts per thousand yen18-30 years of age). We used both upper-limit blood pressure (BP) thresholds for treatment according to Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. uHT was defined as a BP above the threshold. A questionnaire on treatment policies was sent to paediatric and adult nephrologists at eight Dutch transplant centres. Hypertension and uHT were more prevalent in young adult KTRs (86.4 and 75.8%) than in paediatric KTRs (62.7 and 38.3%) according to the KDIGO definition. Time after transplantation was comparable between these groups. Longitudinal analysis showed no evidence of effect of transition on systolic BP or prevalence of uHT. Policies vary considerably between and within centres on the definition of hypertension, BP measurement and antihypertensive treatment. Average BP in KTRs increases continuously with age between 6 and 30 years. Young adult KTRs have significantly more uHT than paediatric KTRs according to KDIGO guidelines. Transition does not influence the prevalence of uHT.",

author = "Dobrowolski, {L. C.} and {van Huis}, A.M. and {van der Lee}, {J. H.} and Sengers, {H. P.} and M.R. Lilien and K. Cransberg and M. Cornelissen and A.H. Bouts and {de Fijter}, {Johan W.} and S.P. Berger and {van Zuilen}, Arjan and Nurmohamed, {S. A.} and M.G.H. Betjes and Luuk Hilbrands and A.J. Hoitsma and F.J. Bemelman and Krediet, {C. T. P.} and Groothoff, {J. W.}",

note = "M1 - 11 ISI Document Delivery No.: ED1HK Times Cited: 1 Cited Reference Count: 47 Dobrowolski, Linn C. van Huis, Maike van der Lee, Johanna H. Sengers, Hessel Peters Lilien, Marc R. Cransberg, Karlien Cornelissen, Marlies Bouts, Antonia H. de Fijter, Johan W. Berger, Stefan P. van Zuilen, Arjan Nurmohamed, Shaikh A. Betjes, Michiel H. G. Hilbrands, Luuk Hoitsma, Andries J. Bemelman, Frederike J. Krediet, Paul Groothoff, Jaap W. Dutch Kidney Foundation [NSNSB137, IP-11.40, KJPB12.29]; ZonMW Clinical Fellowship [40007039712461] We gratefully thank M. Leegte and C. Konijn for their support in data collection from the registry databases, especially M. Leegte for technical support. M.v.H., J.H.v.d.L., A.H.B., M.R.L., M. C., K.C. and J.W.G. participated in this study on behalf of the RICH Q group. RICH Q was granted by the Dutch Kidney Foundation (NSNSB137). We highly appreciate the contribution of all nephrologists who completed the questionnaire. P.K. is supported by grants IP-11.40 and KJPB12.29 from the Dutch Kidney Foundation and ZonMW Clinical Fellowship (40007039712461), which are gratefully acknowledged. 1 5 OXFORD UNIV PRESS OXFORD NEPHROL DIAL TRANSPL",

year = "2016",

doi = "https://doi.org/10.1093/ndt/gfw225",

language = "English",

volume = "31",

pages = "1947--1956",

journal = "Nephrology, dialysis, transplantation",

issn = "0931-0509",

publisher = "Oxford University Press",

}

Dobrowolski, LC, van Huis, AM, van der Lee, JH, Sengers, HP, Lilien, MR, Cransberg, K, Cornelissen, M, Bouts, AH, de Fijter, JW, Berger, SP, van Zuilen, A, Nurmohamed, SA, Betjes, MGH, Hilbrands, L, Hoitsma, AJ, Bemelman, FJ, Krediet, CTP & Groothoff, JW 2016, 'Epidemiology and management of hypertension in paediatric and young adult kidney transplant recipients in The Netherlands: Nephrology Dialysis Transplantation', Nephrology, dialysis, transplantation, vol. 31, pp. 1947-1956. https://doi.org/10.1093/ndt/gfw225

TY - JOUR

T1 - Epidemiology and management of hypertension in paediatric and young adult kidney transplant recipients in The Netherlands

T2 - Nephrology Dialysis Transplantation

AU - Dobrowolski, L. C.

AU - van Huis, A.M.

AU - van der Lee, J. H.

AU - Sengers, H. P.

AU - Lilien, M.R.

AU - Cransberg, K.

AU - Cornelissen, M.

AU - Bouts, A.H.

AU - de Fijter, Johan W.

AU - Berger, S.P.

AU - van Zuilen, Arjan

AU - Nurmohamed, S. A.

AU - Betjes, M.G.H.

AU - Hilbrands, Luuk

AU - Hoitsma, A.J.

AU - Bemelman, F.J.

AU - Krediet, C. T. P.

AU - Groothoff, J. W.

N1 - M1 - 11 ISI Document Delivery No.: ED1HK Times Cited: 1 Cited Reference Count: 47 Dobrowolski, Linn C. van Huis, Maike van der Lee, Johanna H. Sengers, Hessel Peters Lilien, Marc R. Cransberg, Karlien Cornelissen, Marlies Bouts, Antonia H. de Fijter, Johan W. Berger, Stefan P. van Zuilen, Arjan Nurmohamed, Shaikh A. Betjes, Michiel H. G. Hilbrands, Luuk Hoitsma, Andries J. Bemelman, Frederike J. Krediet, Paul Groothoff, Jaap W. Dutch Kidney Foundation [NSNSB137, IP-11.40, KJPB12.29]; ZonMW Clinical Fellowship [40007039712461] We gratefully thank M. Leegte and C. Konijn for their support in data collection from the registry databases, especially M. Leegte for technical support. M.v.H., J.H.v.d.L., A.H.B., M.R.L., M. C., K.C. and J.W.G. participated in this study on behalf of the RICH Q group. RICH Q was granted by the Dutch Kidney Foundation (NSNSB137). We highly appreciate the contribution of all nephrologists who completed the questionnaire. P.K. is supported by grants IP-11.40 and KJPB12.29 from the Dutch Kidney Foundation and ZonMW Clinical Fellowship (40007039712461), which are gratefully acknowledged. 1 5 OXFORD UNIV PRESS OXFORD NEPHROL DIAL TRANSPL

PY - 2016

Y1 - 2016

N2 - Hypertension in kidney transplant recipients (KTRs) is a risk factor for cardiovascular mortality and graft loss. Data on the prevalence of hypertension and uncontrolled hypertension (uHT) in paediatric and young adult KTRs are scarce. Also, it is unknown whether 'transition' (the transfer from paediatric to adult care) influences control of hypertension. We assessed the prevalence of hypertension and uHT among Dutch paediatric and young adult KTRs and analysed the effects of transition. Additionally, we made an inventory of variations in treatment policies in Dutch transplant centres. Cross-sectional and longitudinal national data from living KTRs a parts per thousand currency sign30 years of age (a parts per thousand yen1-year post-transplant, eGFR > 20 mL/min) were extracted from the 'RICH Q' database, which comprises information about all Dutch KTRs <19 years of age, and the Netherlands Organ Transplant Registry database for adult KTRs (a parts per thousand yen18-30 years of age). We used both upper-limit blood pressure (BP) thresholds for treatment according to Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. uHT was defined as a BP above the threshold. A questionnaire on treatment policies was sent to paediatric and adult nephrologists at eight Dutch transplant centres. Hypertension and uHT were more prevalent in young adult KTRs (86.4 and 75.8%) than in paediatric KTRs (62.7 and 38.3%) according to the KDIGO definition. Time after transplantation was comparable between these groups. Longitudinal analysis showed no evidence of effect of transition on systolic BP or prevalence of uHT. Policies vary considerably between and within centres on the definition of hypertension, BP measurement and antihypertensive treatment. Average BP in KTRs increases continuously with age between 6 and 30 years. Young adult KTRs have significantly more uHT than paediatric KTRs according to KDIGO guidelines. Transition does not influence the prevalence of uHT.

AB - Hypertension in kidney transplant recipients (KTRs) is a risk factor for cardiovascular mortality and graft loss. Data on the prevalence of hypertension and uncontrolled hypertension (uHT) in paediatric and young adult KTRs are scarce. Also, it is unknown whether 'transition' (the transfer from paediatric to adult care) influences control of hypertension. We assessed the prevalence of hypertension and uHT among Dutch paediatric and young adult KTRs and analysed the effects of transition. Additionally, we made an inventory of variations in treatment policies in Dutch transplant centres. Cross-sectional and longitudinal national data from living KTRs a parts per thousand currency sign30 years of age (a parts per thousand yen1-year post-transplant, eGFR > 20 mL/min) were extracted from the 'RICH Q' database, which comprises information about all Dutch KTRs <19 years of age, and the Netherlands Organ Transplant Registry database for adult KTRs (a parts per thousand yen18-30 years of age). We used both upper-limit blood pressure (BP) thresholds for treatment according to Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. uHT was defined as a BP above the threshold. A questionnaire on treatment policies was sent to paediatric and adult nephrologists at eight Dutch transplant centres. Hypertension and uHT were more prevalent in young adult KTRs (86.4 and 75.8%) than in paediatric KTRs (62.7 and 38.3%) according to the KDIGO definition. Time after transplantation was comparable between these groups. Longitudinal analysis showed no evidence of effect of transition on systolic BP or prevalence of uHT. Policies vary considerably between and within centres on the definition of hypertension, BP measurement and antihypertensive treatment. Average BP in KTRs increases continuously with age between 6 and 30 years. Young adult KTRs have significantly more uHT than paediatric KTRs according to KDIGO guidelines. Transition does not influence the prevalence of uHT.

U2 - https://doi.org/10.1093/ndt/gfw225

DO - https://doi.org/10.1093/ndt/gfw225

M3 - Article

C2 - 27288460

SN - 0931-0509

VL - 31

SP - 1947

EP - 1956

JO - Nephrology, dialysis, transplantation

JF - Nephrology, dialysis, transplantation

ER -