Background

The most well-known and common long-term complication in children with renal parenchymal scarring (RPS) is hypertension (HT). The present study aimed to evaluate the presence of HT in children with RPS based on ambulatory blood pressure monitoring (ABPM) and to compare the patients’ blood pressure (BP) to that in healthy controls matched for age, gender, and BMI.

Methods

The study included 55 patients aged < 18 years diagnosed with RPS who were followed up for ≥ 1 year and 48 healthy controls matched for age, gender, and BMI.

Results

Mean age in the RPS group was 12.8 ± 3.3 years, and 49.1% of the group were female. Among the RPS patients, 28 were diagnosed with HT based on ABPM, of which 18 (32.7%) had an office BP < 90th percentile for age, gender, and height; seven had an office BP between the 90–95th percentiles for age, gender, and height; and three had an office BP > 95 percentile for age, gender, and height. The difference in detection of HT based on ABPM between the two groups was significant (P = 0.00).

Conclusions

Early diagnosis of HT via ABPM can help prevent development of kidney failure and cardiovascular disease in patients with RPS, significantly reducing the rates of morbidity and mortality. All children with RPS should be evaluated via ABPM, even if office BP measurements are normal.

Graphical abstract

中文翻译：

---

动态血压监测对诊断肾实质瘢痕患者隐匿性高血压的重要性

背景

患有肾实质瘢痕 (RPS) 的儿童最广为人知和最常见的长期并发症是高血压 (HT)。本研究旨在根据动态血压监测 (ABPM) 评估 RPS 儿童中 HT 的存在，并将患者的血压 (BP) 与年龄、性别和 BMI 相匹配的健康对照者的血压进行比较。

方法

该研究包括 55 名诊断为 RPS 且年龄 < 18 岁且随访时间≥ 1 年的患者，以及 48 名年龄、性别和 BMI 相匹配的健康对照。

结果

RPS 组的平均年龄为 12.8 ± 3.3 岁，该组中 49.1% 为女性。在 RPS 患者中，28 例根据 ABPM 被诊断为 HT，其中 18 例 (32.7%) 诊室血压 < 年龄、性别和身高的第 90 个百分位数；7 人的办公室血压在年龄、性别和身高的 90-95% 之间；三人的诊室血压 > 年龄、性别和身高的 95 个百分位数。两组间基于 ABPM 检测 HT 的差异具有显着性（P  = 0.00）。

结论

通过 ABPM 早期诊断 HT 有助于预防 RPS 患者发生肾衰竭和心血管疾病，显着降低发病率和死亡率。所有患有 RPS 的儿童都应通过 ABPM 进行评估，即使诊室血压测量值正常也是如此。

图形概要