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Vol 9, No 6 (2005)
Original paper
Published online: 2005-12-13
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Hypertension treatment preferences in long-term dialysed children in Poland - a survey of pediatric nephrologists

Marcin Tkaczyk, Michał Nowicki, Irena Bałasz-Chmielewska, Anna Boguszewska-Bączkowska, Dorota Drożdż, Barbara Kołłątaj, Tomasz Jarmoliński, Katarzyna Jobs, Katarzyna Kiliś-Pstrusińska, Beata Leszczyńska, Irena Makulska, Dariusz Runowski, Roman Stankiewicz, Maria Szczepańska, Ryszard Wierciński, Ryszard Grenda, Andrzej Kanik, Jacek A. Pietrzyk, Maria Roszkowska-Blaim, Krystyna Szprynger, Jacek Zachwieja, Maria M. Zajączkowska, Walentyna Zoch-Zwierz, Danuta Zwolińska, Aleksandra Żurowska
Nadciśnienie tętnicze 2005;9(6):425-432.

open access

Vol 9, No 6 (2005)
Prace oryginalne
Published online: 2005-12-13

Abstract

Background Chronic kidney disease is associated with the development of arterial hypertension in a vast majority of patients. The treatment of hypertension in these subjects is difficult and challenging due to a limited clinical experience with most drugs and no widely recognised recommendations for patients with end-stage renal disease. A choice of antihypertensive drugs is further narrowed by the young age of the patients since almost all drugs are not recommended in children with renal failure. The aim of this nationwide retrospective analysis was to assess the hypertension treatment patterns in the population of children with chronic kidney diseases (CKD) undergoing hemodialysis or peritoneal dialysis in Poland.
Material and methods Among all 134 children dialysed on 30th November 2004 in 13 pediatric dialysis centres in Poland seventy four (55%; 47M, 27F) children were hypertensive. For each patients the treating physicians filled a questionnaire that allowed to collect the following data: the primary kidney disease, chronic dialysis treatment, diagnostic criteria of hypertension and present antihypertensive medication if any. Additionally we asked of the doctors’ preference for a therapy for the acute rise in blood pressure and suggestions which drugs, in their opinion, should not be used in dialysed children.
Results In the hypertensive dialysed patients the most frequent causes of chronic kidney disease were chronic glomerulopathies (27/74). Thirty two percent of children were on monotherapy whereas 65% required combined treatment. The therapy was adequate only in 58% of subjects. The lowest rate of efficacy was detected in patients requiring a combined antihypertensive therapy. Among antihypertensive drug classes calcium channel blockers were administered most frequently (in 73% of children, in 11/24 cases in monotherapy and in 43/48 patients in combination). Angiotensin converting enzyme inhibitors were most frequently administered in monotheraphy (50%). Nifedipine was preferred in acute blood pressure rise in children.
Conclusion We conclude that incidence of hypertension in dialysed children in Poland is relatively high. The pattern of the treatment was quite uniform, although the efficacy was relatively low (58%).

Abstract

Background Chronic kidney disease is associated with the development of arterial hypertension in a vast majority of patients. The treatment of hypertension in these subjects is difficult and challenging due to a limited clinical experience with most drugs and no widely recognised recommendations for patients with end-stage renal disease. A choice of antihypertensive drugs is further narrowed by the young age of the patients since almost all drugs are not recommended in children with renal failure. The aim of this nationwide retrospective analysis was to assess the hypertension treatment patterns in the population of children with chronic kidney diseases (CKD) undergoing hemodialysis or peritoneal dialysis in Poland.
Material and methods Among all 134 children dialysed on 30th November 2004 in 13 pediatric dialysis centres in Poland seventy four (55%; 47M, 27F) children were hypertensive. For each patients the treating physicians filled a questionnaire that allowed to collect the following data: the primary kidney disease, chronic dialysis treatment, diagnostic criteria of hypertension and present antihypertensive medication if any. Additionally we asked of the doctors’ preference for a therapy for the acute rise in blood pressure and suggestions which drugs, in their opinion, should not be used in dialysed children.
Results In the hypertensive dialysed patients the most frequent causes of chronic kidney disease were chronic glomerulopathies (27/74). Thirty two percent of children were on monotherapy whereas 65% required combined treatment. The therapy was adequate only in 58% of subjects. The lowest rate of efficacy was detected in patients requiring a combined antihypertensive therapy. Among antihypertensive drug classes calcium channel blockers were administered most frequently (in 73% of children, in 11/24 cases in monotherapy and in 43/48 patients in combination). Angiotensin converting enzyme inhibitors were most frequently administered in monotheraphy (50%). Nifedipine was preferred in acute blood pressure rise in children.
Conclusion We conclude that incidence of hypertension in dialysed children in Poland is relatively high. The pattern of the treatment was quite uniform, although the efficacy was relatively low (58%).

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Keywords

arterial hypertension; chronic kidney disease; antihypertensive treatment; chronic dialysis; children

About this article
Title

Hypertension treatment preferences in long-term dialysed children in Poland - a survey of pediatric nephrologists

Journal

Arterial Hypertension

Issue

Vol 9, No 6 (2005)

Article type

Original paper

Pages

425-432

Published online

2005-12-13

Page views

952

Article views/downloads

1575

Bibliographic record

Nadciśnienie tętnicze 2005;9(6):425-432.

Keywords

arterial hypertension
chronic kidney disease
antihypertensive treatment
chronic dialysis
children

Authors

Marcin Tkaczyk
Michał Nowicki
Irena Bałasz-Chmielewska
Anna Boguszewska-Bączkowska
Dorota Drożdż
Barbara Kołłątaj
Tomasz Jarmoliński
Katarzyna Jobs
Katarzyna Kiliś-Pstrusińska
Beata Leszczyńska
Irena Makulska
Dariusz Runowski
Roman Stankiewicz
Maria Szczepańska
Ryszard Wierciński
Ryszard Grenda
Andrzej Kanik
Jacek A. Pietrzyk
Maria Roszkowska-Blaim
Krystyna Szprynger
Jacek Zachwieja
Maria M. Zajączkowska
Walentyna Zoch-Zwierz
Danuta Zwolińska
Aleksandra Żurowska

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