StOPping Hypertension and imprOving Children’s Lives after KidnEy TranSplantation (SOPHOCLES): study protocol for a randomized controlled multicenter trial

Background - Cardiovascular disease is a major morbidity in children after kidney transplantation, limiting life expectancy and impairing graft function. Arterial hypertension is the dominant cardiovascular risk factor and highly abundant in this patient group. Arterial hypertension can cause left v...

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Hauptverfasser: Grabitz, Carl Robert (VerfasserIn) , Memaran, Nima (VerfasserIn) , Sugianto, Rizky (VerfasserIn) , von der Born, Jeanine (VerfasserIn) , Bukova, Mila (VerfasserIn) , Lehmann, Elena (VerfasserIn) , Konuhov, Ann-Kathrin (VerfasserIn) , Holzwart, Dennis (VerfasserIn) , Großhennig, Anika (VerfasserIn) , Wühl, Elke (VerfasserIn) , Schmidt, Bernhard (VerfasserIn) , Melk, Anette (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: December 2025
In: Trials
Year: 2026, Jahrgang: 26, Heft: 1, Pages: 1-11
ISSN:1468-6694
DOI:10.1186/s13063-025-09033-z
Online-Zugang:Resolving-System, kostenfrei, Volltext: https://doi.org/10.1186/s13063-025-09033-z
Verlag, kostenfrei, Volltext: https://www.proquest.com/docview/3244145877/abstract/FDC0B6E529104467PQ/1
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Verfasserangaben:Carl Grabitz, Nima Memaran, Rizky I. Sugianto, Jeanine von der Born, Mila Bukova, Elena Lehmann, Ann-Kathrin Konuhov, Dennis Holzwart, Anika Großhennig, Elke Wühl, Bernhard M. W. Schmidt and Anette Melk

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520 |a Background - Cardiovascular disease is a major morbidity in children after kidney transplantation, limiting life expectancy and impairing graft function. Arterial hypertension is the dominant cardiovascular risk factor and highly abundant in this patient group. Arterial hypertension can cause left ventricular hypertrophy, which is predictive of cardiovascular death. Left ventricular hypertrophy can be non-invasively assessed by measuring left ventricular mass. Observational data indicated that intensified blood pressure control was associated with a significant reduction of left ventricular mass. Based on evidence from the randomized controlled ESCAPE trial, intensified blood pressure control is recommended in children with chronic kidney disease prior to kidney replacement therapy. However, current treatment recommendations for pediatric kidney transplant patients follow the recommendations for otherwise healthy children and adolescents with arterial hypertension, i.e., suggesting a blood pressure target < 90th percentile. - Methods - In the proposed multicenter, randomized, parallel group trial with blinded endpoint evaluation, we aim to include 170 pediatric patients who underwent a kidney transplantation more than 12 months ago. Patients will be randomly assigned 1:1 to an intensified blood pressure management group (blood pressure target ≤ 60th percentile) and a standard blood pressure management group (blood pressure target < 90th percentile). The primary endpoint is left ventricular mass after 24 months. Secondary endpoints are pulse wave velocity, intima media thickness, estimated glomerular filtration rate, and albuminuria. Achievement of blood pressure targets will be facilitated through blood pressure telemonitoring. Blood pressure values will be transmitted in real time to the treating physician and the trial’s centralized study office allowing timely responses in case blood pressure values lie outside target range. - Discussion - The proposed study will result in an evidence-based definition of blood pressure targets and will therefore have direct implications for the care of children after kidney transplantation. In case intensified blood pressure targets are effective, this should eventually lead to lower cardiovascular morbidity and subsequently lower cardiovascular mortality of pediatric kidney transplant recipients. - Trial registration - ClinicalTrials.gov NCT06589947. Registered on September 6, 2024. 
650 4 |a Arterial hypertension 
650 4 |a Cardiorespiratory Medicine and Haematology 
650 4 |a Cardiovascular disease 
650 4 |a Clinical Sciences 
650 4 |a Graft function 
650 4 |a Hypertension 
650 4 |a Intima media thickness 
650 4 |a KeywordsKidney transplantation 
650 4 |a Kidney diseases 
650 4 |a Kidney transplants 
650 4 |a Left ventricular hypertrophy 
650 4 |a Life expectancy 
650 4 |a Medical and Health Sciences 
650 4 |a Morbidity 
650 4 |a Mortality 
650 4 |a Patients 
650 4 |a Pediatrics 
650 4 |a Pulse wave velocity 
650 4 |a Telemonitoring 
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700 1 |a Melk, Anette  |e VerfasserIn  |0 (DE-588)1059888734  |0 (DE-627)798960612  |0 (DE-576)416014186  |4 aut 
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