Authors: Rene’ G VanDeVoorde Gina M Barletta Deepa H Chand Ian G Dresner Jerome Lane Jeffrey Leiser JenJar Lin Cynthia G Pan Hiren Patel Rudolph P Valentini Mark M Mitsnefes
Publish Date: 2006/11/07
Volume: 22, Issue: 4, Pages: 547-553
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 ≥ 95th percentile was found in 42 59 subjects Eleven subjects 155 had prehypertension defined as mean BP between the 90th and 95th percentiles while 18 subjects 253 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 = 003 had higher serum phosphorus p = 001 and had more elevated posttreatment weight above estimated dry weight p = 002 Logistic regression showed that younger age p = 002 and higher serum phosphorus p = 002 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
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