What has changed in the prevalence of hypertension in dialyzed children during the last decade?

Ren Fail. 2017 Nov;39(1):283-289. doi: 10.1080/0886022X.2016.1260033. Epub 2016 Nov 24.

Abstract

Background: Hypertension very often accompanies progression of chronic kidney disease (CKD) in children. A cross-sectional analysis of hypertension prevalence in dialyzed children in Poland was designed with a comparison with the data previously recorded 10 years earlier.

Methods: Two cohorts of children were analyzed: 59 subjects dialyzed in 2013, and 134 children from the previous study performed in 2003 that were reevaluated according to the current methodology. The incidence of hypertension (defined by SDS of sBP or dBP >1.64), clinical data, medical history, dialysis modalities and selected biochemical parameters of dialysis adequacy were analyzed.

Results: The prevalence of hypertension increased from 64% in 2003 to 78% in 2013. The efficacy of antihypertensive treatment remained unsatisfactory (61% proper BP control). Preservation of residual urine output and strict fluid balance may prevent development of hypertension in children on dialysis.

Conclusions: Despite the higher awareness of hypertension and its complications in dialyzed children, the incidence of this entity has increased during the last decade, with the percentage of undertreated patients comparable to that observed 10 years ago. Thus, more attention should be paid to therapy efficacy in this population to prevent further damage to the cardiovascular system and to decrease morbidity.

Keywords: Dialysis; hypertension; pediatrics; prevalence.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Disease Progression*
  • Female
  • Fluid Therapy / methods
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / epidemiology*
  • Incidence
  • Male
  • Pediatrics
  • Poland
  • Renal Insufficiency, Chronic / complications*
  • Risk Factors

Substances

  • Antihypertensive Agents

Grants and funding

The study was partially sponsored by the Polish Ministry of Science and Higher Education, Polish Mother’s Memorial Hospital—Research Institute—Internal Grant no 2012/46 and Polish Society for Pediatric Nephrology.