Prevalence of hypertension in children with early-stage ADPKD(Article)(Open Access)
- aDivision of Nephrology, Department of Pediatric Subspecialties, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
- bPolycystic Kidney Disease Research Group, Laboratory of Pediatrics, Department of Development and Regeneration, Gynaecology Pediatrics and Urology (G-PURE), Katholieke Universiteit Leuven, Leuven, Belgium
- cDepartment of Pediatric Nephrology, University Hospitals Leuven, Leuven, Belgium
- dNephrology Department, University Children’s Hospital, Belgrade, Serbia
- eDepartment of Inherited and Acquired Kidney Diseases, Research and Clinical Institute for Pediatrics, Pirogov Russian National Research Medical University, Moscow, Russian Federation
- fDepartment of Pediatrics, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium
- gDepartment of Nephrology, Kidney Transplantation and Arterial Hypertension, The Children’s Memorial Health Institute, Warsaw, Poland
- hDepartment of Pediatric Nephrology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
- iDepartment of Pediatric Nephrology, Medical University in Lublin, Lublin, Poland
- jInstitute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
- kDepartment of Pediatrics and Nephrology, Medical University of Warsaw, Warsaw, Poland
- lCentro Materno Infantil do Norte, Centro Hospitalar do Porto, Abel Salazar Biomedical Sciences Institute, University of Porto, Porto, Portugal
- mDepartment of Pediatric Nephrology, Assistance Publique Hôpitaux de Paris, Necker Enfant Malades, Descartes University, Paris, France
- nReference Centre of Hereditary Renal Diseases of the Child and Adult, Assistance Publique Hôpitaux de Paris, Necker Enfants Malades, Paris, France
- oDivision of Pediatric Nephrology, Assistance Publique Hôpitaux de Paris, Robert Debré, Sorbonne University, Paris, France
- pPediatric Nephrology Service, University Hospital Vall d’Hebrón, Universidad Autonoma de Barcelona, Barcelona, Spain
- qDivision of Pediatric Nephrology and Rheumatology, Department of Pediatrics, Ankara University Medical School, Ankara, Turkey
- rPediatric Nephrology Unit, Centro Hospitalar São João, Porto, Portugal
- sDivision of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
- tPediatric Nephrology Unit, Bordeaux University Hospital, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche 1219, Bordeaux, France
- uDepartment of Pediatrics, 2nd Medical Faculty, University Hospital Motol, Charles University Prague, Prague, Czech Republic
- vDepartment of Pediatrics of the Faculty of Medicine, Comenius University, Bratislava, Slovakia
- wUniversity Children’s Hospital Bratislava, Bratislava, Slovakia
- xPediatric Nephrology Department, Fundeni Clinical Institute, Bucharest, Romania
- yNephrology Department, University Children’s Hospital and School of Medicine, University of Belgrade, Serbia
- zArterial Hypertension Unit, Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
- aaDepartment of Medical Biometry, Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
- abPediatric Nephrology Division, Center for Pediatrics and Adolescent Medicine, Heidelberg University Hospital, Heidelberg, Germany
- acInstitute of Physiology, University of Zurich, Zurich, Switzerland
- adDivision of Nephrology, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium
Abstract
Background and objectives Autosomal dominant polycystic kidney disease is the most common inheritable kidney disease, frequently thought to become symptomatic in adulthood. However, patients with autosomal dominant polycystic kidney disease may develop signs or symptoms during childhood, in particular hypertension. Although ambulatory BP monitoring is the preferred method to diagnose hypertension in pediatrics, data in children with autosomal dominant polycystic kidney disease are limited. Design, setting, participants, & measurements Our retrospective multicenter study was conducted to collect ambulatory BP monitoring recordings from patients with autosomal dominant polycystic kidney disease age,18 years old. Basic anthropometric parameters as well as data on kidney function, BP treatment, and kidney ultrasound were also collected. Results Data from 310 children with autosomal dominant polycystic kidney disease with a mean age of 11.564.1 years old were collected at 22 European centers. At the time when ambulatory BP monitoring was performed, 95% of children had normal kidney function. Reference data for ambulatory BP monitoring were available for 292 patients. The prevalence rates of children with hypertension and/or those who were treated with antihypertensive drugs were 31%, 42%, and 35% during daytime, nighttime, or the entire 24-hour cycle, respectively. In addition, 52% of participants lacked a physiologic nocturnal BP dipping, and 18% had isolated nocturnal hypertension. Logistic regression analysis showed a significant association between a categorical cyst score that was calculated on the basis of the number of cysts > 1 cm per kidney and daytime hypertension (odds ratio, 1.70; 95% confidence interval, 1.21 to 2.4; P=0.002), nighttime hypertension (odds ratio, 1.31; 95% confidence interval, 1.05 to 1.63; P=0.02), or 24-hour hypertension (odds ratio, 1.39; 95% confidence interval, 1.08 to 1.81; P=0.01). Kidney length, expressed as SD score, was also significantly associated with nighttime hypertension (odds ratio, 1.23; 95% confidence interval, 1.06 to 1.42; P=0.10). Conclusions These data indicate high prevalence of hypertension in children with autosomal dominant polycystic kidney disease starting at young ages. © 2018 by the American Society of Nephrology.
Indexed keywords
| EMTREE drug terms: | antihypertensive agentpolycystin 1polycystin 2 |
|---|---|
| EMTREE medical terms: | adolescentanthropometric parametersArticleblood pressure monitoringchildcircadian rhythmcyst scoredisease activity scoreechographyestimated glomerular filtration ratefemalegene mutationheart ratehumanhypertensionkidney cystkidney functionkidney polycystic diseasemajor clinical studymalemulticenter studyprevalenceretrospective studyrisk factorscoring systemsensitivity analysisultradian rhythmclinical trialcomplicationhypertensionkidney polycystic diseaseprevalencestatistical model |
| MeSH: | AdolescentBlood Pressure Monitoring, AmbulatoryChildFemaleHumansHypertensionLogistic ModelsMalePolycystic Kidney, Autosomal DominantPrevalenceRetrospective StudiesRisk Factors |
Funding details
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1
This study was supported by an impulsion grant provided by the Working Group on Inherited Kidney Disease of the European Renal Association–European Dialysis and Transplant Association.
- ISSN: 15559041
- Source Type: Journal
- Original language: English
- DOI: 10.2215/CJN.11401017
- PubMed ID: 29674338
- Document Type: Article
- Publisher: American Society of Nephrology
Emma, F.; Division of Nephrology, Bambino Gesù Children’s Hospital, Piazza S. Onofrio 4, Rome, Italy;
© Copyright 2018 Elsevier B.V., All rights reserved.
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