Abstract
Background: Hypertension very often accompanies progression of chronic kidney disease (CKD) in children. A cross-sectional analysis of hypertension prevalence in dialyzed children in Poland was designed with a comparison with the data previously recorded 10 years earlier.Methods: Two cohorts of children were analyzed: 59 subjects dialyzed in 2013, and 134 children from the previous study performed in 2003 that were reevaluated according to the current methodology. The incidence of hypertension (defined by SDS of sBP or dBP >1.64), clinical data, medical history, dialysis modalities and selected biochemical parameters of dialysis adequacy were analyzed.Results: The prevalence of hypertension increased from 64% in 2003 to 78% in 2013. The efficacy of antihypertensive treatment remained unsatisfactory (61% proper BP control). Preservation of residual urine output and strict fluid balance may prevent development of hypertension in children on dialysis.Conclusions: Despite the higher awareness of hypertension and its complications in dialyzed children, the incidence of this entity has increased during the last decade, with the percentage of undertreated patients comparable to that observed 10 years ago. Thus, more attention should be paid to therapy efficacy in this population to prevent further damage to the cardiovascular system and to decrease morbidity.
Highlights
Hypertension frequently accompanies progression of chronic kidney disease (CKD) both in children and in adults
Drugs commonly administered in CKD can cause iatrogenic hypertension
The study was designed as a cross-sectional analysis of hypertension prevalence among the Polish population of chronically dialyzed children in the period of April to June 2013
Summary
Hypertension frequently accompanies progression of chronic kidney disease (CKD) both in children and in adults. The percentage of hypertensive patients increases along with the progression of CKD from stage 1 to 5. In the cohorts of dialyzed children, regardless of the populations studied, all the authors reported the values over 70%.1–3. The problem of hypertension in dialyzed children is at least as high as in adult population.. Hypertension very often accompanies progression of chronic kidney disease (CKD) in children. A cross-sectional analysis of hypertension prevalence in dialyzed children in Poland was designed with a comparison with the data previously recorded 10 years earlier. Conclusions: Despite the higher awareness of hypertension and its complications in dialyzed children, the incidence of this entity has increased during the last decade, with the percentage of undertreated patients comparable to that observed 10 years ago. More attention should be paid to therapy efficacy in this population to prevent further damage to the cardiovascular system and to decrease morbidity
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