ESPN 50th Annual Meeting

ESPN 2017


 
Increased central blood pressure and left ventricular mass index in children with ADPKD
MATKO MARLAIS 1 LAURA MILNE 2 CATRIANA CULL 2 SREEDEVI RAJALINGAM 2 MANISH SINHA 2 PAUL WINYARD 1

1- UCL GREAT ORMOND STREET INSTITUTE OF CHILD HEALTH
2- EVELINA LONDON CHILDRENS HOSPITAL
 
Introduction:

Central blood pressure (cBP) and pulse wave velocity (PWV) have not previously been reported in children with Autosomal dominant polycystic kidney disease (ADPKD). The aim of this study was to measure BP components [peripheral BP (pBP) and cBP], carotid-femoral PWV (PWVcf), indexed left ventricular mass (LVMI) and microalbuminuria in children with ADPKD.

Material and methods:

This was a multi-centre prospective observational study of children (aged <18) with a confirmed diagnosis of ADPKD. Comparisons were made against a group of age-matched healthy controls. All children underwent manual pBP, cBP measurement using radial applanation tonometry and PWVcf measured using the SphygmoCor device. Indexed LV mass (LVMI) was measured using standard 2D m-mode echocardiography.

Results:

38 children with ADPKD and 49 healthy controls were recruited from two paediatric nephrology centres (mean age 12.1 years vs. 12.2 years). Children with ADPKD had significantly higher systolic pBP (mean 113mmHg vs. 104mmHg, p<0.001) and systolic cBP (mean 96mmHg vs. 87mmHg, p<0.001) compared to healthy children. There was no difference in PWVcf between children with ADPKD and healthy children (mean 5.67m/s vs. 5.57m/s, p=0.67). Children with ADPKD had a significantly higher LVMI (mean 30.6 g/m2.7 vs. 26.2 g/m2.7, p=0.01) compared to healthy children. 50% with ADPKD had evidence of microalbuminuria with an abnormal albumin:creatinine ratio.

Conclusions:

This study found that children with ADPKD have higher peripheral and central BP than healthy children. We observed no evidence of increased arterial stiffening although children with ADPKD had higher LVMI and microalbuminuria than healthy children. Further research is required to understand the mechanisms of elevated BP in children with ADPKD and its influence on the evolution of target organ damage.