Day- and night-time blood pressure elevation in children with higher grades of renal scarring

• Published in: The Journal of pediatrics 2003-02, Vol.142 (2), p.117-122
• Main Authors: Patzer, Ludwig, Seeman, Tomas, Luck, Carmen, Wühl, Elke, Janda, Jan, Misselwitz, Joachim
• Format: Article
• Language: English
• Subjects: Age Factors; Biological and medical sciences; Blood Pressure Monitoring, Ambulatory - methods; Blood Pressure Monitoring, Ambulatory - standards; Case-Control Studies; Child; Circadian Rhythm; Diastole; Female; Glomerular Filtration Rate; Humans; Hypertension - diagnosis; Hypertension - etiology; Kidney Diseases - classification; Kidney Diseases - complications; Kidney Diseases - diagnosis; Male; Malformations of the urinary system; Mass Screening - methods; Mass Screening - standards; Medical sciences; Multivariate Analysis; Nephrology. Urinary tract diseases; Radiopharmaceuticals; Recurrence; Reference Values; Sensitivity and Specificity; Severity of Illness Index; Systole; Technetium Tc 99m Dimercaptosuccinic Acid; Urinary Tract Infections - complications; Urinary tract. Prostate gland; Vesico-Ureteral Reflux - complications
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1067/mpd.2003.13

Objective We used 24-hour ambulatory blood pressure measurement (ABPM) to screen for early changes in children with renal scarring compared with healthy controls, and we investigated correlations between the extent of renal damage and blood pressure (BP). Study design Untreated patients (n = 61) with renal scars associated with recurrent urinary tract infection and vesico-ureteric reflux were investigated and compared with 904 healthy controls. Results A significant positive correlation between the extent of renal scarring and systolic and diastolic BP standard deviation score (SDS) was found by using ABPM. Mean systolic day-time BP SDS in ABPM was significantly elevated in girls with renal scars compared with healthy controls, but failed to be significant in boys. Mean systolic and diastolic night-time BP SDS were significantly elevated in patients. Compatible with these results, diastolic dipping was significantly lower in patients compared with controls. Conclusions The increase in BP obtained by ABPM is positively correlated with the degree of scarring in our group of patients. Elevated night-time BP might be the most sensitive indicator of BP elevation in these children. (J Pediatr 2003;142:117-22.)