Ali Düzova1, Aysun Karabay Bayazit2, Nur Canpolat3, Anna Niemirska4, Ipek Kaplan Bulut5, Karolis Azukaitis6, Tevfik Karagoz7, Berna Oguz8, Sevcan Erdem9, Ali Anarat2, Bruno Ranchin10, Rukshana Shroff11, Milan Djukic12, Jerome Harambat13, Alev Yilmaz14, Nurdan Yildiz15, Birsin Ozcakar16, Anja Büscher17, Francesca Lugani18, Simone Wygoda19, Sibylle Tschumi20, Ariane Zaloszyc21, Augustina Jankauskiene22, Guido Laube23, Matthias Galiano24, Marietta Kirchner25, Uwe Querfeld26, Anette Melk27, Franz Schaefer28, Elke Wühl28. 1. Division of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara. 2. Cukurova University Faculty of Medicine, Adana. 3. Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey. 4. The Children's Memorial Health Institute, Warsaw, Poland. 5. Ege University Faculty of Medicine, Izmir, Turkey. 6. Clinic of Pediatrics, Faculty of Medicine, Vilnius, Lithuania. 7. Division of Pediatric Cardiology. 8. Department of Radiology, Hacettepe University Faculty of Medicine, Ankara. 9. Division of Pediatric Cardiology, Cukurova University Faculty of Medicine, Adana, Turkey. 10. Hospices Civils de Lyon, Bron, France. 11. Great Ormond Street Hospital for Children, London, UK. 12. School of Medicine, University of Belgrade, Belgrade, Serbia. 13. Pediatric Nephrology Unit, Bordeaux University Hospital, Bordeaux, France. 14. Istanbul University Istanbul Medical Faculty. 15. Marmara University Faculty of Medicine, Istanbul. 16. Division of Pediatric Nephrology and Rheumatology, Department of Pediatrics, Ankara University Medical School, Ankara, Turkey. 17. University Children's Hospital, Pediatrics 2, Pediatric Nephrology, University of Duisburg-Essen, Essen, Germany. 18. Division of Nephrology and Transplantation, G. Gaslini Institute, Genova, Italy. 19. Klinikum St. Georg, Leipzig, Germany. 20. Pediatric Nephrology, Inselspital, Bern, Switzerland. 21. CHU Hautepierre, Strasbourg, France. 22. Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania. 23. Nephrology Unit, University Children's Hospital, Zürich, Switzerland. 24. Department of Pediatrics and Adolescent Medicine, University of Erlangen-Nuremberg, Erlangen. 25. Institute of Medical Biometry and Informatics, Heidelberg. 26. Charité Universitätsmedizin Berlin, Berlin. 27. Hannover Medical School, Hannover. 28. Center for Pediatrics and Adolescent Medicine, University of Heidelberg, Heidelberg, Germany.
Abstract
INTRODUCTION: Prevalence of isolated nocturnal hypertension (INH) and isolated daytime hypertension (IDH) is around 10% in adults. Data in children, especially in chronic kidney disease (CKD), are lacking. The aim of this cross-sectional multicenter cohort study was to define the prevalence of INH and IDH and its association with cardiovascular morphology and function, that is, pulse wave velocity (PWV), carotid intima-media thickness (cIMT), or left ventricular mass index (LVMI) in children with CKD. METHODS: Ambulatory blood pressure (BP) monitoring profiles were analyzed in 456 children with CKD stages III-V participating in the Cardiovascular Comorbidity in Children with Chronic Kidney Disease Study (64.3% males, 71.3% congenital anomaly of the kidney and urinary tract, age 12.5 ± 3.2 years, estimated glomerular filtration rate 29 ± 12 ml/min per 1.73 m). Baseline PWV, cIMT, and LVMI were compared in normotension, INH, IDH, or sustained 24-h hypertension. RESULTS: Prevalence of sustained hypertension was 18.4%, of INH 13.4%, and of IDH 3.7%. PWV SDS (SD score) and cIMT SDS were significantly higher in sustained hypertension and INH, and PWV SDS was significantly higher in IDH, compared with normotension. LVMI was significantly increased in sustained hypertension, but not in INH or IDH. Determinants of INH were smallness for gestational age, older age, higher height SDS and parathyroid hormone, and shorter duration of CKD. In logistic regression analysis, day/night-time hypertension or ambulatory BP monitoring pattern (normal, INH, IDH, sustained hypertension) were independently associated with cardiovascular outcome measures: elevated night-time BP was associated with increased cIMT, PWV, and left ventricular hypertrophy; INH was associated with cIMT. CONCLUSION: INH is present in almost one out of seven children with predialysis CKD; INH and nocturnal hypertension in general are associated with alterations of arterial morphology and function.
INTRODUCTION: Prevalence of isolated nocturnal hypertension (INH) and isolated daytime hypertension (IDH) is around 10% in adults. Data in children, especially in chronic kidney disease (CKD), are lacking. The aim of this cross-sectional multicenter cohort study was to define the prevalence of INH and IDH and its association with cardiovascular morphology and function, that is, pulse wave velocity (PWV), carotid intima-media thickness (cIMT), or left ventricular mass index (LVMI) in children with CKD. METHODS: Ambulatory blood pressure (BP) monitoring profiles were analyzed in 456 children with CKD stages III-V participating in the Cardiovascular Comorbidity in Children with Chronic Kidney Disease Study (64.3% males, 71.3% congenital anomaly of the kidney and urinary tract, age 12.5 ± 3.2 years, estimated glomerular filtration rate 29 ± 12 ml/min per 1.73 m). Baseline PWV, cIMT, and LVMI were compared in normotension, INH, IDH, or sustained 24-h hypertension. RESULTS: Prevalence of sustained hypertension was 18.4%, of INH 13.4%, and of IDH 3.7%. PWV SDS (SD score) and cIMT SDS were significantly higher in sustained hypertension and INH, and PWV SDS was significantly higher in IDH, compared with normotension. LVMI was significantly increased in sustained hypertension, but not in INH or IDH. Determinants of INH were smallness for gestational age, older age, higher height SDS and parathyroid hormone, and shorter duration of CKD. In logistic regression analysis, day/night-time hypertension or ambulatory BP monitoring pattern (normal, INH, IDH, sustained hypertension) were independently associated with cardiovascular outcome measures: elevated night-time BP was associated with increased cIMT, PWV, and left ventricular hypertrophy; INH was associated with cIMT. CONCLUSION: INH is present in almost one out of seven children with predialysis CKD; INH and nocturnal hypertension in general are associated with alterations of arterial morphology and function.
Authors: Monica L Guzman-Limon; Shuai Jiang; Derek Ng; Joseph T Flynn; Bradley Warady; Susan L Furth; Joshua A Samuels Journal: Hypertension Date: 2022-08-18 Impact factor: 9.897
Authors: Rizky Indrameikha Sugianto; Karen Ostendorf; Nima Memaran; Anette Melk; Elena Bauer; Jeannine von der Born; Jun Oh; Markus J Kemper; Rainer Buescher; Bernhard M W Schmidt Journal: Pediatr Nephrol Date: 2022-09-12 Impact factor: 3.651
Authors: Anna Végh; Adrienn Bárczi; Orsolya Cseprekál; Éva Kis; Kata Kelen; Szilárd Török; Attila J Szabó; György S Reusz Journal: Front Med (Lausanne) Date: 2021-12-16