44-h ambulatory blood pressure monitoring: revealing the true burden of hypertension in pediatric hemodialysis patients

Haskin, Orly; Wong, Cynthia; McCabe, Lonisa; Begin, Brandy; Sutherland, Scott M.; Chaudhuri, Abanti

doi:10.1007/s00467-014-2964-7

Cited by 21 publications

(8 citation statements)

References 35 publications

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“…Paglialonga et al retrospectively analyzed 16 oligoanuric children and found significant correlation between IDWG and left ventricular mass index (LVMI) with significant correlation between IDWG and DBP [3]. Haskin et al performed 44 hr ambulatory blood pressure monitoring (ABPM) on 13 pediatric HD patients and found that with longer monitoring (1 day versus 2 days) more pts were found to be hypertensive, with moderate positive correlation between BP and IDWG, concluding that as fluid accumulates during the interdialytic period it contributes to increased BP load [2]. …”

Section: Discussionmentioning

confidence: 99%

“…Similarly to other studies in pediatric hemodialysis, our study has disadvantages that include small number of subjects, retrospective design, and single center experience [2, 3, 11]. As only retrospective data that were part of routine clinical care were collected, our study lacks dietary salt intake records, ambulatory blood pressure monitor studies, 3 or more BP measurements before HD, daily urine output, daily weight, and ambulatory BP measurements.…”

Section: Discussionmentioning

confidence: 99%

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Relationship between Interdialytic Weight Gain and Blood Pressure in Pediatric Patients on Chronic Hemodialysis

Marsenić

Anderson

Couloures

2016

BioMed Research International

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Overhydration is reported to be the main cause of hypertension (HTN) as well as to have no association with HTN in hemodialysis (HD) population. This is the first report of the relationship between interdialytic weight gain (IDWG) and pre-HD blood pressure (BP) in pediatric patients in relation to residual urine output (RUO). We studied 170 HD sessions and interdialytic periods performed during a 12-week period in 5 patients [age 4–17 years, weight 20.8–66 kg, 3 anuric (102 HD sessions), and 2 nonanuric (68 HD sessions)]. BP is presented as systolic BP index (SBPI) and diastolic BP index (DBPI), calculated as systolic or diastolic BP/95th percentile for age, height, and gender. IDWG did not differ (P > 0.05) between anuric and nonanuric pts. There was a positive but not significant correlation between IDWG and both pre-HD SBPI (r = 0.833, P = 0.080) and pre-HD DBPI (r = 0.841, P = 0.074). Pre-HD SBPI (1.01 ± 0.12 versus 1.13 ± 0.18) and DBPI (0.92 ± 0.16 versus 1.01 ± 0.24) were higher in nonanuric patents (P < 0.001 and P < 0.01, resp.). Pre-HD HTN may not be solely related to IDWG and therapies beyond fluid removal may be needed. Individualized approach to HTN management is necessary in pediatric dialysis population.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Relationship between Interdialytic Weight Gain and Blood Pressure in Pediatric Patients on Chronic Hemodialysis

Marsenić

Anderson

Couloures

2016

BioMed Research International

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“…Role of IDWG in HTN is unclear. While some report overhydration as the main cause of HTN, others find that it is frequently not associated with HTN, in both adults and children . Recommendations to decrease dNa are made to improve IDWG by decreasing Na load and thirst .…”

Section: Discussionmentioning

confidence: 99%

“…While some report overhydration as the main cause of HTN, others find that it is frequently not associated with HTN, in both adults and children. 2,8,9,27,[38][39][40][41] Recommendations to decrease dNa are made to improve IDWG by decreasing Na load and thirst. 2,7,42 Aggressive fluid removal used for high IDWG may lead to intradialytic hypotension, with reduction of blood flow to vital organs.…”

Section: Discussionmentioning

confidence: 99%

Effect of the decrease in dialysate sodium in pediatric patients on chronic hemodialysis

Marsenić

Anderson

Couloures

et al. 2015

Hemodialysis International

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Optimal dialysate sodium (dNa) is unknown, with both higher and lower values suggested in adult studies to improve outcomes. Similar studies in pediatric hemodialysis (HD) population are missing. This is the first report of the effect of two constant dNa concentrations in pediatric patients on chronic HD. 480 standard HD sessions and interdialytic periods were studied in 5 patients (age 4-17 years, weight 20.8-66 kg) during a period of 6-11 months per patient. dNa was 140 mEq/L during the first half, and 138 mEq/L during the second half of the study period for each patient. Lowering dNa was associated with improved preHD hypertension, decreased interdialytic weight gain, decreased need for ultrafiltration, lower sodium gradient and was well tolerated despite lack of concordance with predialysis sNa, that was variable. Further studies are needed to verify our findings and to investigate if an even lower dNa may be more beneficial in the pediatric HD population.

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“…ACE inhibitors reduce left ventricular mass and decrease the mean arterial blood pressure. 32,33 In hypertensive pediatric dialyzed population, renal artery stenosis is not frequent, and other contraindications, such as pregnancy and breast-feeding, can be neglected. Thus, this group of drugs both with ARB seems to be the safest.…”

Section: New Scopes For Better Blood Pressure Controlmentioning

confidence: 99%

Antihypertensive treatment prescription in pediatric dialysis patients in Poland: A comparison between two nationwide studies 2003/2004–2013

Wróblewski

Hincz²,

Miklaszewska

et al. 2017

Adv Clin Exp Med

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44-h ambulatory blood pressure monitoring: revealing the true burden of hypertension in pediatric hemodialysis patients

Abstract: The 44-h ABPM provides more information than the 24-h ABPM in terms of diagnosing and assessing the true burden of hypertension in pediatric HD patients. Elevated BP loads from 44-h ABPM correlate with a higher LVMI on the echocardiogram.

Cited by 21 publications

References 35 publications

Relationship between Interdialytic Weight Gain and Blood Pressure in Pediatric Patients on Chronic Hemodialysis

Relationship between Interdialytic Weight Gain and Blood Pressure in Pediatric Patients on Chronic Hemodialysis

Effect of the decrease in dialysate sodium in pediatric patients on chronic hemodialysis

Antihypertensive treatment prescription in pediatric dialysis patients in Poland: A comparison between two nationwide studies 2003/2004–2013

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