Good long-term renal graft survival and low incidence of cardiac pathology in adults after short dialysis period and renal transplantation in early childhood - a cohort study.

Autor: Hölttä T; Department of Pediatric Nephrology and Transplantation, The New Children's Hospital, HUS Helsinki University Hospital, Helsinki, Finland., Gordin D; Abdominal Center Nephrology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.; Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Helsinki, Finland.; Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.; Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA., Rahkonen O; Department of Pediatric Cardiology, The New Children's Hospital, HUS Helsinki University Hospital, Helsinki, Finland., Turanlahti M; Department of Pediatric Cardiology, The New Children's Hospital, HUS Helsinki University Hospital, Helsinki, Finland., Holmström M; Radiology, HUS Medical Imaging Center, HUS Helsinki University Hospital, Helsinki, Finland., Tainio J; Department of Pediatric Nephrology and Transplantation, The New Children's Hospital, HUS Helsinki University Hospital, Helsinki, Finland., Rönnholm K; Department of Pediatric Nephrology and Transplantation, The New Children's Hospital, HUS Helsinki University Hospital, Helsinki, Finland., Jalanko H; Department of Pediatric Nephrology and Transplantation, The New Children's Hospital, HUS Helsinki University Hospital, Helsinki, Finland.
Jazyk: angličtina
Zdroj: Transplant international : official journal of the European Society for Organ Transplantation [Transpl Int] 2020 Jan; Vol. 33 (1), pp. 89-97. Date of Electronic Publication: 2019 Oct 08.
DOI: 10.1111/tri.13521
Abstrakt: Over the past 30 years, there has been an improvement in both patient and graft survival after pediatric renal transplantation (RTX). Despite this success, these patients still carry an elevated risk for untimely death, partly through premature aging of the vasculature. The aim of this study was thus to investigate the long-term outcome of individuals with RTX in childhood, as well as to explore the cardiovascular health of these adults more than a decade later. We studied 131 individuals who had undergone a RTX between the years 1979 and 2005. Furthermore, left ventricular hypertrophy (LVH), coronary artery calcifications (CAC), and related metabolic factors were investigated in a cross-sectional study including 52 individuals as part of the initial cohort. The mortality rate (n = 131) was 12.2%. The median estimated graft survival was 17.5 years (95% CI 13.6-21.3), being significantly better in children transplanted below the age of 5 years (18.6 vs. 14.3 years, P < 0.01) compared with older ones. CAC were found in 9.8% and LVH in 13% of the patients. Those with cardiac calcifications had longer dialysis vintage and higher values of parathyroid hormone (PTH) during dialysis. Left ventricular mass correlated positively with systolic blood pressure, PTH, and phosphate measured at the time of the study.
(© 2019 Steunstichting ESOT.)
Databáze: MEDLINE
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