Faculty Collaboration Database

Blood pressure control in pediatric hemodialysis: the Midwest Pediatric Nephrology Consortium Study. Pediatr Nephrol 2007 Apr;22(4):547-53

Date

11/23/2006

Pubmed ID

17115195

DOI

10.1007/s00467-006-0341-x

Scopus ID

2-s2.0-33847390357 (requires institutional sign-in at Scopus site)   27 Citations

Abstract

Hypertension is frequent in pediatric patients receiving dialysis, with an especially high rate reported in children on hemodialysis (HD). We performed the present study to assess blood pressure (BP) status and identify risk factors for poor BP control in children on maintenance HD. One month's dialysis records were collected from 71 subjects receiving HD in ten dialysis units participating in the Midwest Pediatric Nephrology Consortium (MWPNC). For each HD session, data on pre- and posttreatment weights and BPs were recorded. Hypertension, defined as mean BP >or= 95th percentile, was found in 42 (59%) subjects. Eleven subjects (15.5%) had prehypertension, defined as mean BP between the 90th and 95th percentiles, while 18 subjects (25.3%) had normal BP (<90th percentile). BP significantly decreased at the end of a dialysis session; however, only 15 of 42 hypertensive subjects (35%) normalized their BP. Hypertensive subjects were younger (p = 0.03), had higher serum phosphorus (p = 0.01), and had more elevated posttreatment weight above estimated dry weight (p = 0.02). Logistic regression showed that younger age (p = 0.02) and higher serum phosphorus (p = 0.02) independently predicted hypertensive status. In conclusion, this study emphasizes the difficulty of BP control in pediatric HD patients. Especially poor BP control was found in younger children; those patients who do not reach their posttreatment weight goals, perhaps reflecting their hypervolemic state; and those who have higher serum phosphorus levels.

Author List

VanDeVoorde RG, Barletta GM, Chand DH, Dresner IG, Lane J, Leiser J, Lin JJ, Pan CG, Patel H, Valentini RP, Mitsnefes MM

Author

Cynthia G. Pan MD Adjunct Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Blood Pressure
Blood Pressure Determination
Blood Volume
Child
Child, Preschool
Cross-Sectional Studies
Female
Humans
Hypertension
Male
Renal Dialysis
Retrospective Studies
Risk Factors