The Factors Affecting Blood Pressure in Pediatric Renal Transplant Recipients M. Tu ¨ rkmen, S. Kavukc ¸ u, A. Soylu, B. Kasap, S. Bora, and H. Gu ¨ lay ABSTRACT To investigate the parameters affecting systemic blood pressure in pediatric renal transplant recipients, we retrospectively examined the data from 19 adolescent renal transplant recipients including 6 girls overall, mean age of 15,47  3.56 years. Serum creatinine (Scr), fractional extraction of sodium (FENa), whole blood trough cyclospori- ne(C0), plasma total cholesterol (TC) and triglyceride levels, and systolic and diastolic blood pressure (SBP and DBP) were monitored during a total of 677 visits. SBP and DBP, classified as 95p (groups 1s and 1d) and 95p (groups 2s and 2d), were correlated with differences between groups 1 and 2. Group 2s Scr and FENa levels were higher than group 1s (P = .002 and P = .048, respectively), whereas C0 and FENa levels were higher in Group 2d than Group 1d (P = 0.028 and P = 0.036, respectively). Among the entire group, SBP and DBP positively correlated with C0; Scr and SBP, with FENa. While there was a positive correlation between SBP and C0 in groups 1s and 2s (r = 0.188, P  .000; and r = 0.145, P = .040), DBP was only associated with C0 in group 1d (P = .03, r = 0.156). In contrast, DBP showed a positive correlation with Scr in group 2d (P = .023, r = 0.132), and SBP with Scr in Group 1s. C0 and Scr levels were correlated in Groups 1s, 1d and 2d. At high BP levels (95p), SBP is mostly affected by C0; DBP, with Scr. However, in both groups these two parameters positively correlate with each other. Thus, in adolescent renal transplant recipients the cause of high blood pressure does not appear to be solely related to cyclosporine related to induced allograft dysfunction. H YPERTENSION is a frequent complication in chil- dren and adolescents with renal transplantation with a prevalence between 70% and 80%. 1 The cause is multi- factorial, including immunosuppressive therapy, chronic graft rejection, and prior hypertension. 2 Factors such as age, gender, and race play only minor roles in posttrans- plant hypertension. 3 As in adults, high BP in children with renal transplants is associated with allograft dysfunction or failure and LVH. 1 The aim of the study was to determine biochemical parameters affecting blood pressure levels among pediatric renal transplant recipients. MATERIALS AND METHODS The data from 19 pediatric recipients 13 boys, 6 girls of renal transplants between April 1993 and March 2003 were analyzed retrospectively with a mean follow-up of 55.21  27.85 (8 –104) months. All patients received cyclosporine (CsA), prednisolone and azathioprine. No patient had undergone native nephrectomy. Serum creatinine (S cr ), fractional extraction of sodium (FE Na ), glomerular filtration rates (GFR) calculated according to the Schwartz formula, whole blood trough CsA (C 0 ), plasma total cholesterol (TC) and triglyceride (TG) levels, and blood pressures were monitored at regular visits. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) measurements were classified as 95p [Gr1 s (n = 463), Gr1 d (n = 365)] or 95p [Gr2 s (n = 214), Gr2 d (n = 305)]. Correlation of SBP and DBP with demographic and clinical parameters was sought by a Pearson analysis. RESULTS Among the entire group, SBP and DBP levels positively correlated with C 0 and S Cr . SBP also correlated with FeNa, From the Dokuz Eylu ¨ l University, Faculty of Medicine, Depart- ments of Pediatrics (M.T., S.K., A.S., B.K.) and General Surgery (S.B., H.G.), Izmir, Turkey. Address reprint requests to Salih Kavukc ¸ u, MD, Mithatpas ¸a Cad. No:665/4 35280 Ku ¨c ¸u ¨ kyali Izmir, Turkey. E-mail: s.kavukcu@deu.edu.tr 0041-1345/04/$–see front matter © 2004 by Elsevier Inc. All rights reserved. doi:10.1016/j.transproceed.2003.11.036 360 Park Avenue South, New York, NY 10010-1710 150 Transplantation Proceedings, 36, 150-151 (2004)