ESPN 50th Annual Meeting

ESPN 2017


 
ARTERIAL HYPERTENSION IN CHILDREN AFTER DIARRHEA-ASSOCIATED HEMOLYTIC UREAMIC SYNDROM
S.V. BAIKO 1 A.V. SUKALO 1 N.N. ABROSIMOVA 2

1- BELARUSIAN STATE MEDICAL UNIVERSITY
2- 2ND CHILDRENS HOSPITAL
 
Introduction:

 

Arterial hypertension (AH) is one of the most common complications after diarrhea-associated hemolytic uremic syndrome (HUS). 

Aim of study was to determine the incidence and characteristics of arterial hypertension in children after HUS, to assess circadian rhythm and blood pressure (BP) variability.

 

 

 

Material and methods:

The study included 59 children, aged 7,5±1,9 years and follow-up of HUS 5,12±2,07 years. All patients underwent daily blood pressure monitoring (ABPM), determined daily urine losses of protein and albumin.

Results:

AH was diagnosed in 16 (27,1%) children (9 with antihypertensive therapy and 7 without it). According ABPM established the prevalence of different forms of AH in children after HUS: prehypertension in 10,2% of patients, white coat hypertension in 13,6% and masked AH in 6,8%. AH was detected with high frequency as those who received dialysis in the acute period of HUS, so without it (29,6% and 20%, respectively). High blood pressure was defined mainly at night due to systolic BP with high load and insufficient night dipping. In some patients obesity worsened the systolic hypertension, which persisted throughout the day. Microalbuminuria was found in 50% of children with hypertension and was closely correlated with the severity of renal damage in the acute period of HUS (rs =0,4; p<0,05) and AH (rs =0,41, p<0,05).

Conclusions:

Considering the predominantly nocturnal AH in children after HUS, 24h monitoring of blood pressure is given a key role in its diagnosis. The detection of pathological microalbuminuria is the indication for carrying out ABPM, even if normal office blood pressure.