Ambulatory Blood Pressure Monitoring in Children With Vesicoureteral Reflux

Objective To assess the value of ambulatory blood pressure monitoring (ABPM) for identifying the risk of hypertension (HT) in children with vesicoureteral reflux (VUR). Methods Seventy-six children with primary VUR were enrolled. Patients were divided into 2 groups according to renal scarring (RS)....

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Bibliographic Details
Published in:Urology (Ridgewood, N.J.) N.J.), 2014-04, Vol.83 (4), p.899-903
Main Authors: Yavuz, Sevgi, Anarat, Ali, Bayazıt, Aysun Karabay
Format: Article
Language:English
Subjects:
Adolescent
Anthropometry
Biological and medical sciences
Blood Pressure
Blood Pressure Monitoring, Ambulatory - methods
Child
Child, Preschool
Cicatrix - pathology
Creatinine - blood
Creatinine - urine
Female
Glomerular Filtration Rate
Humans
Hypertension - complications
Hypertension - diagnosis
Kidney - pathology
Male
Medical sciences
Nephrology. Urinary tract diseases
Proteinuria - diagnosis
Risk
Urinary system involvement in other diseases. Miscellaneous
Urinary tract. Prostate gland
Urology
Vesico-Ureteral Reflux - physiopathology
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Summary:Objective To assess the value of ambulatory blood pressure monitoring (ABPM) for identifying the risk of hypertension (HT) in children with vesicoureteral reflux (VUR). Methods Seventy-six children with primary VUR were enrolled. Patients were divided into 2 groups according to renal scarring (RS). Serum creatinine, urine protein, and urine creatinine were measured. All patients underwent ABPM and casual blood pressure (BP) examination. ABPM measurements were standardized to age, gender, and height by Lambda-Mu-Sigma method. Results Urine protein and creatinine concentrations were statistically higher in RS (+) group than RS (−) group ( P  = .05). Casual systolic and diastolic BP standard deviation score (SDS) values were not statistically different between RS (+) and RS (−) groups. Day, night and 24-hour systolic BP SDS, day and 24-hour mean arterial blood pressure SDS values were significantly higher in RS (+) group than that of RS (−) group ( P  = .015, P  = .031, P  = .013, P  = .07, and P  = .021, respectively). All ABPM values significantly increased in patients with severe RS compared with ones with mild and moderate RS ( P  .05). Conclusion ABPM is more sensitive than casual BP measurements and might be used for early identification of HT in VUR patients. The severity of RS increases the risk of HT in children with VUR. Controlling HT with proteinuria would decrease the progression of renal damage in VUR.
ISSN:0090-4295
1527-9995
DOI:10.1016/j.urology.2013.10.008