ESPN 51th Annual Meeting

ESPN 2018


 
APPROACHES OF PEDIATRIC NEPHROLOGISTS TO HYPERTENSIVE PATIENTS IN TURKEY (TURKISH PEDIATRIC HYPERTENSION WORKING GROUP STUDY)
Belde Kasap Demir 1 Mehmet Taşdemir 2 Duygu Övünç Hacıhamdioğlu 3 İlknur Girişgen 4 Hasan Dursun 5 Mahmut Çivilibal 6 Meryem Benzer 7 Neşe Karaaslan Bıyıklı 8 Neşe Özkayın 9 Ferah Sönmez 10

1- Division of Pediatric Nephrology, Department of Pediatrics, İzmir Katip Çelebi University, İzmir, Turkey
2- Division of Pediatric Nephrology, Department of Pediatrics, Koç University School of Medicine, Istanbul, Turkey
3- Division of Pediatric Nephrology, Department of Pediatrics, Bahçeşehir University School of Medicine, Istanbul, Turkey
4- Division of Pediatric Nephrology, Department of Pediatrics, Pamukkale University School of Medicine, Denizli, Turkey
5- Division of Pediatric Nephrology, Department of Pediatrics, Okmeydanı Education and Research Hospital, Istanbul, Turkey
6- Division of Pediatric Nephrology, Department of Pediatrics, Istanbul Memorial Bahcelievler Hospital, Altınbaş University School of Medicine, Istanbul, Turkey
7- Division of Pediatric Nephrology, Denge Private Health Services Company, Istanbul, Turkey
8- Division of Pediatric Nephrology, Anadolu Medical Center Hospital, Kocaeli, Turkey
9- Division of Pediatric Nephrology, Department of Pediatrics, Trakya University School of Medicine, Edirne, Turkey
10- Division of Pediatric Nephrology, Department of Pediatrics, Adnan Menderes University School of Medicine, Aydın, Turkey
 
Introduction:

 We aimed to evaluate the approaches of pediatric nephrologists to children/adolescents with hypertension in our country.   

Material and methods:

 The study consisted of a questionnaire including 24 questions about personal information, diagnosis, evaluation and treatment. Clinicians were divided into two groups: those working in the field of pediatric nephrology for 10years (Group, n:74) or >10years (Group2,n:62). The answers were compared between the groups.

Results:

Of 136 clinicians, 16% were using the Fourth Report, 27% were using 2017 AAP, 9% were using 2016 ESH and 48% were using more than one guideline. The most common choice to diagnose HT was office+home+ambulatory BP monitoring (%59). Frequency of screening for end-organ damage at first evaluation was 96%. The most frequently used method was echocardiography+microalbuminuria+ophthalmologic examination (76%). Target thresholds for treatment was consistent with the last guideline in 32%. Life-style changes were followed for one month in 35%, 3 months in 52% and ≥6 months in 13%. The first choice medication was ACEI(49%) or CCB(48%) in non-obese children; ACEI (74%) in obese children. The most frequently added medication was 44% CCB and 43% ACEI in non-obese and 50% CCB in obese children. The first choice ACEI was enalapril (76%), ARB was losartan (94%), CCB was amlodipine (92%) and diuretic was furosemide (77%). Eighty-six percent preferred to check biochemical parameters one week after prescription of RAAS blockers. Frequency of prescribing anti-HT drugs after a hypertensive emergency was 92%. When compared between the groups: following a single guideline was more frequent in Group1(p:0.035). Group2 was more frequently using Fourth Report (p:0.042). Evaluating home BPs for ≤ 2weeks to diagnose HT was more frequent in Group1. Prescribing CCB as the first choice in non-obese children was higher in Group1 (p:0.035). 

Conclusions:

 The time spent in profession would change the preferences of pediatric nephrologists in evaluating patients with HT.