ESPN 50th Annual Meeting

ESPN 2017


 
Ambulatory Blood Pressure Monitoring in Patients with Multicystic Dysplastic Kidney
ESRA PEHLIVAN 1 NUR CANPOLAT 2 AYSE KALYONCU UCAR 3 RUMEYSA YASEMIN CICEK 2 ISMET DEMIR 4 SALIM CALISKAN 2 FATMA LALE SEVER 2

1- ISTANBUL UNIVERSITY CERRAHPASA MEDICAL FACULTY, DEPARTMENT OF PEDIATRICS
2- ISTANBUL UNIVERSITY CERRAHPASA MEDICAL FACULTY, DEPARTMENT OF PEDIATRIC NEPHROLOGY
3- ISTANBUL UNIVERSITY CERRAHPASA MEDICAL FACULTY, DEPARTMENT OF PEDIATRIC RADIOLOGY
4- ISTANBUL UNIVERSITY ISTANBUL MEDICAL FACULTY, DEPARTMENT OF BIOCHEMISTRY
 
Introduction:

The prevalence of hypertension in children with multicystic dysplastic kidney (MCDK) varies between 0 to 8% based on casual blood pressure (BP) measurements. However; there is limited data on the prevalence of hypertension evaluated by ambulatory blood pressure monitoring (ABPM) in these patients and the rate is up to 20%. The aims of the present study were to evaluate prevalence of and risk factors for ambulatory hypertension in children with MCDK.

Material and methods:

This cross-sectional single center study enrolled 31 children (16 male, aged 5-17 years) with MCDK and age, gender and BMI similar 20 healthy children. All subjects were evaluated by casual and ambulatory BP measurements. Ambulatory BP findings were classified according to the updated American Heart Association recommendations in children. Plasma renin activity (PRA) was measured in all patients and controls. Renal ultrasound examinations were performed in the patient group. Total renal volume was calculated and adjusted to height (defined as renal volume index). 

Results:

There were no differences in SD scores of ABPM values between the patient and the control groups. Three patients (9.6%) were diagnosed as hypertensive based on ABPM; two were classified as masked hypertension and one as sustained hypertension. In addition, two patients had white coat hypertension (WCH) and another two had prehypertension. In the control group, only one patient had WCH.

There was no difference in PRA levels between the patient and control groups. Five patients (16%) had accompanying urological abnormalities in the contralateral kidney and 26 (84%) showed compensatory hypertrophy. None of the three hypertensive patients had contralateral urological abnormality; while only one did not reveal compensatory hypertrophy. There was no significant relationship between renal volume index and ABPM values.

Conclusions:

The mechanism(s) of hypertension in patients with MCDK is obscure. Further studies with larger sample sizes are needed to clarify pathogenesis of hypertension in these patients.