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Vol 23, No 1 (2019)
Original paper
Published online: 2019-02-19
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Ambulatory blood pressure monitoring and subclinical inflammation in children with chronic kidney disease

Piotr Skrzypczyk1, Michał Szyszka2, Anna Ofiara2, Beata Leszczyńska1, Dominika Adamczuk1, Maria Daniel1, Małgorzata Pańczyk-Tomaszewska1
DOI: 10.5603/AH.a2019.0003
·
Arterial Hypertension 2019;23(1):14-21.
Affiliations
  1. Department of Pediatrics and Nephrology, Medical University of Warsaw, Warsaw, Poland
  2. Student Scientific Group at the Department of Pediatrics and Nephrology, Medical University of Warsaw, Warsaw, Poland

open access

Vol 23, No 1 (2019)
ORIGINAL PAPERS
Published online: 2019-02-19

Abstract

Background. Children with chronic kidney disease (CKD) are characterized by increased risk of hypertension and
chronic low-grade inflammation. The aim of the study was the analysis of relation between parameters of ambulatory
blood pressure monitoring (ABPM) and subclinical inflammation in children with CKD.

Material and methods. Study group included 27 paediatric patients (age 14.23 ± 3.57 years) with CKD stage 2–5;
18 children with previously recognized hypertension. In all patients we evaluated ABPM, office blood pressure,
complete blood count and selected clinical and biochemical parameters.

Results. In the study group, GFR was from 7.05 to 86.73, mean 40.88 ± 25.82 mL/min/1.73 m2. All 9 children
without hypertension had normal blood pressure in ABPM, but ABPM detected poor blood pressure control in 7
among 18 (38.9%) children with previously recognized and treated hypertension. Abnormal circadian blood pressure
profile was found in 12 (44.4%) children: 9/18 (50.0%) with hypertension and 3/9 (33.3%) with normal BP. Systolic,
diastolic, mean blood pressure and diastolic blood pressure load correlated with neutrophil count, neutrophilto-
lymphocyte ratio and platelet-to-lymphocyte ratio (r = 0.39–0.49, p = 0.010–0.044); diastolic and mean blood
pressure and diastolic blood pressure load with parathormone (r = 0.48–0.57, p = 0.005–0.023); diastolic blood
pressure load with phosphate and calcium-phosphorus product (r = 0.44–0.47, p = 0.021-0.030); diastolic blood
pressure dipping with phosphate (r = –0.43, p = 0.034).

Conclusions. 1. Ambulatory blood pressure monitoring should be used in children with chronic kidney disease on a
regular basis, especially in those with arterial hypertension. 2. Blood pressure in children with chronic kidney disease
may be related to degree of subclinical inflammation.

Abstract

Background. Children with chronic kidney disease (CKD) are characterized by increased risk of hypertension and
chronic low-grade inflammation. The aim of the study was the analysis of relation between parameters of ambulatory
blood pressure monitoring (ABPM) and subclinical inflammation in children with CKD.

Material and methods. Study group included 27 paediatric patients (age 14.23 ± 3.57 years) with CKD stage 2–5;
18 children with previously recognized hypertension. In all patients we evaluated ABPM, office blood pressure,
complete blood count and selected clinical and biochemical parameters.

Results. In the study group, GFR was from 7.05 to 86.73, mean 40.88 ± 25.82 mL/min/1.73 m2. All 9 children
without hypertension had normal blood pressure in ABPM, but ABPM detected poor blood pressure control in 7
among 18 (38.9%) children with previously recognized and treated hypertension. Abnormal circadian blood pressure
profile was found in 12 (44.4%) children: 9/18 (50.0%) with hypertension and 3/9 (33.3%) with normal BP. Systolic,
diastolic, mean blood pressure and diastolic blood pressure load correlated with neutrophil count, neutrophilto-
lymphocyte ratio and platelet-to-lymphocyte ratio (r = 0.39–0.49, p = 0.010–0.044); diastolic and mean blood
pressure and diastolic blood pressure load with parathormone (r = 0.48–0.57, p = 0.005–0.023); diastolic blood
pressure load with phosphate and calcium-phosphorus product (r = 0.44–0.47, p = 0.021-0.030); diastolic blood
pressure dipping with phosphate (r = –0.43, p = 0.034).

Conclusions. 1. Ambulatory blood pressure monitoring should be used in children with chronic kidney disease on a
regular basis, especially in those with arterial hypertension. 2. Blood pressure in children with chronic kidney disease
may be related to degree of subclinical inflammation.

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Keywords

children; chronic kidney disease; hypertension; ambulatory blood pressure monitoring; inflammation

About this article
Title

Ambulatory blood pressure monitoring and subclinical inflammation in children with chronic kidney disease

Journal

Arterial Hypertension

Issue

Vol 23, No 1 (2019)

Article type

Original paper

Pages

14-21

Published online

2019-02-19

Page views

933

Article views/downloads

856

DOI

10.5603/AH.a2019.0003

Bibliographic record

Arterial Hypertension 2019;23(1):14-21.

Keywords

children
chronic kidney disease
hypertension
ambulatory blood pressure monitoring
inflammation

Authors

Piotr Skrzypczyk
Michał Szyszka
Anna Ofiara
Beata Leszczyńska
Dominika Adamczuk
Maria Daniel
Małgorzata Pańczyk-Tomaszewska

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