Assessment of Hypertension in Children With Autosomal Dominant Polycystic Kidney Disease; Single-Center Experience

Abstract

Autosomal dominant polycystic kidney disease (ADPKD) is one of the most common hereditary renal cystic diseases. Although its clinical manifestations usually occur in adulthood, hypertension (HT) is known to develop in most patients before the decline in renal function and it is associated with faster progression to end stage kidney disease (ESKD). We investigated ambulatory blood pressure monitoring (ABPM) results of 23 patients with ADPKD, followed up in the Pediatric Nephrology Clinic of Ondokuz Mayıs University Medical Faculty Hospital. Patients’ demographic characteristics, laboratory and ultrasonography (US) results, office blood pressure, and ABPM measurements were evaluated. The parameters of gender, age, increased kidney size, proteinuria, glomerular filtration rate (GFR) was compared in hypertensive and non-hypertensive group. Twenty three patients (13 girls, ten boys) with a mean age of 11.94±4.01 (min-max: 4.6-18) years and a female/male ratio of 1.3/1 were examined. Ultrasound revealed increased kidney sizes in 12 patients (52.2%) and multiple cysts in the bilateral kidneys in 20 patients (87%). Mild to moderate proteinuria was detected in 7 patients (30.4%). The HT ratio of patients was 52.2% and 39.1% when assessed with office blood pressure (BP) measurement and ABPM respectively. A non-dipper pattern was established in 14 patients (60.9%). Gender, age, increased kidney size, proteinuria, GFR did not differ significantly between ADPKD patients with and without ambulatory HT. This study shows that nearly half of children with ADPKD have HT by ABPM. BP should be regularly screened by ABPM in all pediatric ADPKD patients.