Ambulatory hypertension prevalent in children with autosomal recessive polycystic kidney disease

Children with autosomal recessive polycystic kidney disease (ARPKD) are at greater odds of ambulatory hypertension even as the control of this condition improves over time, a study has shown.

A team of investigators conducted a retrospective study and assessed 36 children with ARPKD and at least one ambulatory blood pressure monitoring (ABPM) and 29 children with at least two ABPM.

Ambulatory hypertension was defined as mean daytime or night-time BP at least 95th percentile or use of antihypertensives and controlled hypertension as normal ambulatory BP in children on antihypertensive medications.

In the first ABPM study, ambulatory hypertension was diagnosed in 94 percent of children. Untreated or uncontrolled ambulatory hypertension was detected in 67 percent and controlled hypertension in only 28 percent. Furthermore, masked and white-coat hypertension were found in 5.5 percent and 14 percent, respectively.

In the last ABPM study, ambulatory hypertension was found in 86 percent of children, while the prevalence of controlled hypertension rose to 59 percent. Masked and white-coat hypertension were diagnosed in 8.3 percent and 10 percent, respectively.

Of note, ambulatory BP was not associated with either kidney length or glomerular filtration rate. Additionally, echocardiography revealed left ventricular hypertrophy in 27 percent of children at the time of their first ABPM.

“Arterial hypertension is a common complication in patients with ARPKD, occurring in 33–75 percent of children when measured by office blood pressure (OBP),” the investigators said, adding that ABPM is a superior tool for examining blood pressure relative to OBP.