ESPN 51th Annual Meeting

ESPN 2018


 
AMBULATORY BLOOD PRESSURE MONITORING IN AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE IN CHILDREN
EBRU YILMAZ 1 NIDA TEMIZKAN DINCEL 1 CEMALIYE BASARAN 1 SERKAN KEMER 1 ORHAN DENIZ KARA 1 AYSE CAKIL 1 ERKIN SERDAROGLU 1

1- UNIVERSITY OF HEALTH SCIENCES DR. BEHCET UZ CHILDRENS HOSPITAL DEPARTMENT OF PEDIATRIC NEPHROLOGY
 
Introduction:

Hypertension (HT) is a significant independent risk factor for progression to end stage renal disease. The prevalence of HT was reported 10 to 20% in children with autosomal dominant polycystic disease (ADPKD) although normal renal function. The aim of the study was to identify HT in children in ADPKD using by ambulatory blood pressure monitoring (ABPM).

Material and methods:

Office blood pressure (BP) was measured from the right arm with proper sized cuff after 20 min of resting. BP more than 95percentile for sex and height percentile was considered HT. ABMP was done using by SpaceLabs 21907 device. BP load and mean BP values was used ambulatory HT. Dipping was calculated the percentage of the decrease of values during the night and day. The diagnosis of ADPKD was based on family history and ultrasound examination according to defined criteria.

Results:

Twenty-nine (15 female) children with the mean age of 13.5±3.8 years were enrolled to the study. At the time of the study all patients were asymptomatic, had normal office BP also normal glomerular filtration rates (≥65 ml/min/1.73 m²). Thirteen patients (44.8%) were defined as HT by casual measurements of BP at office. ABPM was hypertensive in 7 patients (24%) and target organ damage was found in 4 patients (3 on heart, 1 in eye). Proteinuria was found in 46.2% of HT in office and 42.9% of HT in ABPM. The nocturnal dip was reduced in 42% patients. Neither patient was diagnosed as masked hypertension, but 6 patients had white coat hypertension. BP dipping was not different between normo/hypertensive.

Conclusions:

ABPM helps to make an early diagnosis of HT and should be identify patients with white coat hypertension in ADPKD. Proteinuria and hypertension management and treatment is crucial for ADPKD patients.