ABPM AND END ORGAN DAMAGE IN CHILDREN WITH RENAL TRANSPLANTATION

肾移植儿童的动态血压监测和终末器官损伤

• 批准号: 7374523
• 负责人: MARK M. MITSNEFES
• 金额: $ 0.12万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-12-01 至 2006-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7374523
• 关键词: ABPM; END; ORGAN; DAMAGE; CHILDREN

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Recent studies showed that nighttime hypertension as determined by ambulatory BP monitoring (ABPM) occurs almost universally in both adults and children after renal transplantation (Tx). We hypothesize that after renal Tx, increased nighttime BP in children who had normal office BP, will be associated with hypertension-related end-organ damage such as increased left ventricular mass (LVM), increased arterial stiffness and decreased kidney function. If nighttime BP is a better predictor of target organ damage than office BP, the use of ABPM would detect patients at risk and provide the rational guideline for therapy. To test this concept, we will assess in children with renal Tx cardiovascular structure and function and allograft function at baseline and after one year. Cardiac structure will be evaluated by measurement of LVM, vascular structure and function by measurement of carotid artery intima-media thickness (IMT) and allograft function by measurement of glomerular filtration rate (GFR). These measurements will be correlated with multiple variables, the most important of which will be daytime and nighttime BP as measured by ABPM. Hypertension is a strong and independent risk factor for poor long-term outcome in adults and children with renal Tx. It is hoped that improved detection of hypertension by 24-hour ABPM, especially nighttime hypertension, will lead to more effective treatment which will prevent or slow the progression of cardiac disease and allograft dysfunction. Thus, the long-term goal will be to decrease the incidence and prevalence of cardiovascular disease and delay graft failure in children and young adults with renal Tx.

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。最近的研究表明，由动态血压监测(ABPM)确定的夜间高血压几乎普遍存在于成人和儿童肾移植(TX)后。我们推测，在肾TX后，办公室血压正常的儿童夜间血压增加将与高血压相关的终末器官损害相关，如左室质量(LVM)增加、动脉僵硬和肾功能下降。如果夜间血压比办公室血压能更好地预测靶器官损害，则动态血压监测将发现有危险的患者，并为治疗提供合理的指导。为了测试这一概念，我们将在基线和一年后评估患有肾脏TX的儿童的心血管结构和功能以及同种异体移植的功能。通过测量LVM评价心脏结构，通过测量颈动脉内中膜厚度(IMT)评价血管结构和功能，通过测量肾小球滤过率(GFR)评价同种异体移植物功能。这些测量将与多个变量相关，其中最重要的变量将是ABPM测量的白天和夜间血压。高血压是成人和儿童肾TX患者长期预后差的独立危险因素。人们希望，24小时动态血压监测的改进，特别是夜间高血压的检测，将导致更有效的治疗，从而预防或减缓心脏病和移植物功能障碍的进展。因此，长期目标将是降低患有肾脏TX的儿童和年轻人心血管疾病的发生率和患病率，并延迟移植失败。