Steroid withdrawal improves blood pressure control and nocturnal dipping in pediatric renal transplant recipients: analysis of a prospective, randomized, controlled trial

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064203%3A_____%2F19%3A10394228" target="_blank" >RIV/00064203:_____/19:10394228 - isvavai.cz</a>

Alternative codes found

RIV/00216208:11130/19:10394228 RIV/00216208:11140/19:10394228

Result on the web

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=TcpSD4kuRH" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=TcpSD4kuRH</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1007/s00467-018-4069-1" target="_blank" >10.1007/s00467-018-4069-1</a>

Result language

angličtina

Original language name

Steroid withdrawal improves blood pressure control and nocturnal dipping in pediatric renal transplant recipients: analysis of a prospective, randomized, controlled trial

Original language description

BackgroundVariable effects of steroid minimization strategies on blood pressure in pediatric renal transplant recipients have been reported, but data on the effect of steroid withdrawal on ambulatory blood pressure and circadian blood pressure rhythm have not been published so far.MethodsIn a prospective, randomized, multicenter study on steroid withdrawal in pediatric renal transplant recipients (n=42) on cyclosporine, mycophenolate mofetil, and methylprednisolone, we performed a substudy in 28 patients, aged 11.23.8years, for whom ambulatory blood pressure monitoring (ABPM) data were available.ResultsIn the steroid-withdrawal group, the percentage of patients with arterial hypertension, defined as systolic and/or diastolic blood pressure values recorded by ABPM &gt;1.64 SDS and/or antihypertensive medication, at month 15 was significantly lower (35.7%, p=0.002) than in controls (92.9%). The need of antihypertensive medication dropped significantly by 61.2% (p&lt;0.000 vs. control), while in controls, it even rose by 69.3%. One year after steroid withdrawal, no patient exhibited hypertensive blood pressure values above the 95th percentile, compared to 35.7% at baseline (p=0.014) and to 14.3% of control (p=0.142). The beneficial impact of steroid withdrawal was especially pronounced for nocturnal blood pressure, leading to a recovered circadian rhythm in 71.4% of patients vs. 14.3% at baseline (p=0.002), while the percentage of controls with an abnormal circadian rhythm (35.7%) did not change.Conclusions Steroid withdrawal in pediatric renal transplant recipients with well-preserved allograft function is associated with less arterial hypertension recorded by ABPM and recovery of circadian blood pressure rhythm by restoration of nocturnal blood pressure dipping.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

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OECD FORD branch

30217 - Urology and nephrology

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2019

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Pediatric Nephrology

ISSN

0931-041X

e-ISSN

—

Volume of the periodical

34

Issue of the periodical within the volume

2

Country of publishing house

DE - GERMANY

Number of pages

8

Pages from-to

341-348

UT code for WoS article

000455660600017

EID of the result in the Scopus database

2-s2.0-85053421824