PD31-05 HYPERTENSION FOLLOWING RENAL TRAUMA IN A PEDIATRIC POPULATION

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: External Genitalia Reconstruction and Urotrauma (including transgender surgery) II (PD31)1 Sep 2021PD31-05 HYPERTENSION FOLLOWING RENAL TRAUMA IN A PEDIATRIC POPULATION Catalina K. Hwang, Vishnu Iyer, Judith C. Hagedorn, and Alexander J. Skokan Catalina K. HwangCatalina K. Hwang More articles by this author , Vishnu IyerVishnu Iyer More articles by this author , Judith C. HagedornJudith C. Hagedorn More articles by this author , and Alexander J. SkokanAlexander J. Skokan More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002032.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Hypertension (HTN) has a reported incidence of around 4% after pediatric renal trauma. Risk factors for long-term HTN include medial parenchymal lacerations, high AAST injury grade, and HTN in the acute postinjury period. Little is known about BP trends over time to guide decision-making on the duration of monitoring. We hypothesized that most postinjury HTN spontaneously resolves, with an incidence of sustained HTN similar to the general population. METHODS: We retrospectively reviewed records of all pediatric renal trauma patients (<18 years) who presented to our Level 1 trauma center from 2010-2019 for demographic, injury characteristics and follow-up data. Only routine follow-up visits were included. BPs were graded based on age-, sex- and height-normalized data to identify normotension, elevated BP (EBP), and HTN per age-appropriate guidelines. HTN is a subset of EBP. At least 3 follow-up BP readings was required for inclusion criteria. RESULTS: From a total of 179 patients, 97 met inclusion criteria. No patients were discharged on antihypertensives. Median follow-up duration was 32 (IQR 6-65) months. On follow-up, 67% were always normotensive and 33% had EBP. 23% had HTN. Of those with EBP, 41% had onset at injury with persistence, 31% had late onset after initial normotension, and 28% had initial EBP that later spontaneously resolved. The time to late onset or resolution of EBP/HTN was variable, occurring at respective means of 50 (SD 41) and 18.6 (SD 37.5) months. The incidence of postinjury EBP was significantly higher in males (p=0.003). No other variables had a statistically significant relationship with long-term EBP (Table 2). Four patients (11.4%) with EBP had this finding addressed at an outpatient visit. Two patients were started on antihypertensives by an outpatient provider in follow-up. CONCLUSIONS: Postinjury HTN is more common than previously reported, and is not routinely recognized or addressed when present in follow-up. Up to 1/3 of those with early HTN will have spontaneous resolution, but HTN can also develop in a delayed manner in some patients. Patient/parent counseling is important to raise awareness and encourage routine monitoring after discharge. Further work is necessary to determine risk factors for chronic HTN, and indications for long-term follow-up and medical intervention. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e540-e540 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Catalina K. Hwang More articles by this author Vishnu Iyer More articles by this author Judith C. Hagedorn More articles by this author Alexander J. Skokan More articles by this author Expand All Advertisement Loading ...