Prominent publications by Joseph Thomas Flynn

KOL Index score: 14949

Left ventricular hypertrophy (LVH) associates with increased risk for cardiovascular disease. Hypertension leads to LVH in adults, but its role in the pathogenesis of LVH in children is not as well established. To examine left ventricular mass and evaluate factors associated with LVH in children with stages 2 through 4 chronic kidney disease (CKD), we analyzed cross-sectional data from children who had baseline echocardiography (n = 366) and underwent ambulatory BP monitoring (n = 226) ...

Also Ranks for: Ventricular Hypertrophy |  lvh children |  masked hypertension |  ambulatory monitoring |  cardiovascular disease
KOL Index score: 14919

BACKGROUND: Few studies have prospectively evaluated the progression of chronic kidney disease (CKD) in children and adolescents, as well as factors associated with progression.

STUDY DESIGN: Prospective multicenter observational cohort study.

SETTING & PARTICIPANTS: 496 children and adolescents with CKD enrolled in the Chronic Kidney Disease in Children (CKiD) Study.

PREDICTORS: Proteinuria, hypoalbuminemia, blood pressure, dyslipidemia, and anemia.

OUTCOMES: Parametric failure-time ...

Also Ranks for: Kidney Disease |  children ckd |  rapid progression |  composite event |  50 decline
KOL Index score: 12770

OBJECTIVE: To determine whether casual blood pressure (BP) or ambulatory BP monitoring (ABPM) measurements obtained at the initial visit of a child with confirmed hypertension (HTN) might predict left ventricular hypertrophy (LVH), possibly obviating the need for echocardiography.

STUDY DESIGN: We conducted a cross-sectional study of 184 children aged 3 to 20 years who were referred for initial evaluation of elevated BP at 3 tertiary care centers. Casual BP and various ambulatory BP ...

Also Ranks for: Ventricular Hypertrophy |  lvh children |  blood pressure |  primary hypertension |  ambulatory child child
KOL Index score: 11375

BACKGROUND: Ambulatory blood pressure monitoring (ABPM) is widely utilized for the evaluation and management of hypertension in adults but has not been routinely used in the care of hypertensive children.

DESIGN: To examine the potential impact that the routine use of ABPM might have on the evaluation and management of hypertension in children, we reviewed our early experience with this technique, comparing management decisions based on ABPM with those based on casual blood pressure ...

Also Ranks for: Blood Pressure |  hypertension children |  evaluation management |  abpm studies |  ambulatory child child
KOL Index score: 11260

Cyclosporin (Cs-A) is an effective treatment for difficult cases of nephrotic syndrome (NS), but its use can be complicated by renal toxicity and a high incidence of relapses after withdrawal. We reviewed the charts of 10 Cs-A-dependent patients and 4 patients with steroid-dependent nephrotic syndrome (SDNS) not previously treated with Cs-A therapy. All patients had persistent NS, even after prior treatment with oral cyclophosphamide. Of 10 patients treated with Cs-A, 4 had surveillance ...

Also Ranks for: Mmf Patients |  mycophenolate mofetil |  frequency relapses |  sdns csa |  nonsteroidal child child
KOL Index score: 10347

To characterize the distribution of blood pressure (BP), prevalence, and risk factors for hypertension in pediatric chronic kidney disease, we conducted a cross-sectional analysis of baseline BPs in 432 children (mean age 11 years; 60% male; mean glomerular filtration rate 44 mL/min per 1.73 m(2)) enrolled in the Chronic Kidney Disease in Children cohort study. BPs were obtained using an aneroid sphygmomanometer. Glomerular filtration rate was measured by iohexol disappearance. Elevated ...

Also Ranks for: Chronic Kidney Disease |  blood pressure |  antihypertensive medications |  kidney failure |  glomerular filtration
KOL Index score: 10117

Ambulatory blood pressure (BP) monitoring (ABPM) is the best method of detecting abnormal BP in patients with chronic kidney disease (CKD), whose hypertension may be missed with casual BP measurements. We report ABPM findings in 332 children 1 year after entry in the Chronic Kidney Disease in Children cohort study. All of the subjects underwent casual and ambulatory BP measurement. BP was categorized based on casual and ABPM results into normal (42%), white-coat (4%), masked (35%), and ...

Also Ranks for: Chronic Kidney Disease |  ambulatory blood |  enzyme inhibitors |  abpm children |  hypertension kidney
KOL Index score: 9835

Dyslipidemia, a known risk factor for atherosclerosis, is frequent among both adults and children with chronic kidney disease. Here, we describe the prevalence and pattern of dyslipidemia from a cross-sectional analysis of 391 children aged 1-16 years, enrolled in the multicenter Chronic Kidney Disease in Children (CKiD) study, with a median glomerular filtration rate (GFR), measured by the plasma disappearance of iohexol, of 43 ml/min per 1.73 m2. Multivariate analysis was applied to ...

Also Ranks for: Kidney Disease |  dyslipidemia children |  bmi gfr |  ckid study |  cholesterol hdl
KOL Index score: 9676

PURPOSE: Renal transplantation in children with end stage renal disease due to congenital urological malformations has traditionally been associated with a poor outcome compared to transplantation in those with a normal urinary tract. In addition, the optimal urological treatment for such children remains unclear. To address these issues, we retrospectively reviewed our experience with renal transplantation in this population.

MATERIALS AND METHODS: Between 1986 and 1998, 12 boys and 6 ...

Also Ranks for: Renal Transplantation |  urinary tract |  severe lower |  serum creatinine |  11 children
KOL Index score: 9658

These pediatric hypertension guidelines are an update to the 2004 "Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents." Significant changes in these guidelines include (1) the replacement of the term "prehypertension" with the term "elevated blood pressure," (2) new normative pediatric blood pressure (BP) tables based on normal-weight children, (3) a simplified screening table for identifying BPs needing further evaluation, (4) a ...

Also Ranks for: Clinical Practice Guideline |  pressure blood |  diagnosis management |  heart association |  ambulatory monitoring
KOL Index score: 9594

OBJECTIVE: To determine whether ambulatory blood pressure monitoring (ABPM) can help differentiate children with secondary hypertension from those with primary hypertension.

METHODS: Ninety-seven ABPM studies obtained from 85 children followed in a pediatric hypertension clinic were analyzed. Forty studies were performed in patients with primary hypertension, and 57 studies were performed in patients with secondary hypertension. Mean patient age was 13.8 +/- 3.5 [mean +/- standard ...

Also Ranks for: Secondary Hypertension |  ambulatory blood |  pressure monitoring |  children abpm |  detailed evaluation
KOL Index score: 9392

The efficacy and safety of valsartan were studied in 90 children (mean age: 3.2 years; 60% male; 30% black) with systolic blood pressure (SBP) > or =95th percentile. Nineteen percent received valsartan in addition to previous antihypertensive therapy. Subjects were randomly assigned to low-, medium-, or high-dose valsartan for 2 weeks (phase 1) and then reassigned randomly to placebo or to remain on the same valsartan dose for 2 additional weeks (phase 2). After this, subjects were ...

Also Ranks for: Angiotensin Receptor |  children age |  safety valsartan |  2 weeks |  95th percentile
KOL Index score: 9246

BACKGROUND AND OBJECTIVES: Children with chronic kidney disease (CKD) are at risk for cognitive dysfunction, and over half have hypertension. Data on the potential contribution of hypertension to CKD-associated neurocognitive deficits in children are limited. Our objective was to determine whether children with CKD and elevated BP (EBP) had decreased performance on neurocognitive testing compared with children with CKD and normal BP.


Also Ranks for: Chronic Kidney Disease |  neurocognitive function |  blood pressure |  children ckd |  child behavior
KOL Index score: 8764

BACKGROUND AND OBJECTIVES: Dyslipidemia, a risk factor for cardiovascular disease, is common in CKD but its change over time and how that change is influenced by concurrent progression of CKD have not been previously described.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In the CKD in Children study we prospectively followed children with progressive CKD and utilized multivariable, linear mixed-effects models to quantify the longitudinal relationship between within-subject changes in ...

Also Ranks for: Children Ckd |  filtration rate |  proteinuria renal |  cardiovascular disease |  independently concomitant
KOL Index score: 8538

BACKGROUND AND OBJECTIVES: Congenital anomalies of the kidney and urinary tract and genetic disorders cause most cases of CKD in children. This study evaluated the relationships between baseline proteinuria and BP and longitudinal changes in GFR in children with these nonglomerular causes of CKD.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Urine protein-to-creatinine ratio, casual systolic and diastolic BP (normalized for age, sex, and height), and GFR decline were assessed in the ...

Also Ranks for: Pediatric Ckd |  ckid cohort |  baseline gfr |  progression children |  urinary tract

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Joseph Thomas Flynn:Expert Impact

Concepts for whichJoseph Thomas Flynnhas direct influence:Blood pressure,  Chronic kidney disease,  Antihypertensive medications,  Severe hypertension,  Primary hypertension,  Peritoneal dialysis,  Kidney disease,  Ventricular hypertrophy.

Joseph Thomas Flynn:KOL impact

Concepts related to the work of other authors for whichfor which Joseph Thomas Flynn has influence:Blood pressure,  Chronic kidney disease,  Children adolescents,  Peritoneal dialysis,  Type 1 diabetes,  Metabolic syndrome,  Pediatric patients.



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Seattle Children's Hospital, Seattle, Washington. | Department of Pediatrics, Division of Nephrology, Seattle Children’s Hospital, 4800 Sand Point Way NE, OC.9.820 – Nephrology, Seattle, WA 98105, USA | Division of Nephrology, Seattle Children’s Hosp