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Original ArticlesCystic Kidney Disease
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Prevalence of Hypertension in Children with Early-Stage ADPKD

Laura Massella, Djalila Mekahli, Dušan Paripović, Larisa Prikhodina, Nathalie Godefroid, Anna Niemirska, Ayşe Ağbaş, Karolina Kalicka, Augustina Jankauskiene, Malgorzata Mizerska-Wasiak, Alberto Caldas Afonso, Rémi Salomon, Georges Deschênes, Gema Ariceta, Z. Birsin Özçakar, Ana Teixeira, Ali Duzova, Jérôme Harambat, Tomáš Seeman, Gabriela Hrčková, Adrian Catalin Lungu, Svetlana Papizh, Amira Peco-Antic, Stéphanie De Rechter, Ugo Giordano, Marietta Kirchner, Teresa Lutz, Franz Schaefer, Olivier Devuyst, Elke Wühl and Francesco Emma
CJASN June 2018, 13 (6) 874-883; DOI: https://doi.org/10.2215/CJN.11401017
Laura Massella
1Division of Nephrology, Department of Pediatric Subspecialties, and
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Djalila Mekahli
2Polycystic Kidney Disease Research Group, Laboratory of Pediatrics, Department of Development and Regeneration, Gynaecology Pediatrics and Urology (G-PURE), Katholieke Universiteit Leuven, Leuven, Belgium;
3Department of Pediatric Nephrology, University Hospitals Leuven, Leuven, Belgium;
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Dušan Paripović
4Nephrology Department, University Children’s Hospital, Belgrade, Serbia;
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Larisa Prikhodina
5Department of Inherited and Acquired Kidney Diseases, Research and Clinical Institute for Pediatrics, Pirogov Russian National Research Medical University, Moscow, Russia;
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  • ORCID record for Larisa Prikhodina
Nathalie Godefroid
6Department of Pediatrics, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium;
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Anna Niemirska
7Department of Nephrology, Kidney Transplantation and Arterial Hypertension, The Children’s Memorial Health Institute, Warsaw, Poland;
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Ayşe Ağbaş
8Department of Pediatric Nephrology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey;
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Karolina Kalicka
9Department of Pediatric Nephrology, Medical University in Lublin, Lublin, Poland;
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Augustina Jankauskiene
10Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania;
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Malgorzata Mizerska-Wasiak
11Department of Pediatrics and Nephrology, Medical University of Warsaw, Warsaw, Poland;
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Alberto Caldas Afonso
12Centro Materno Infantil do Norte, Centro Hospitalar do Porto, Abel Salazar Biomedical Sciences Institute, University of Porto, Porto, Portugal;
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Rémi Salomon
13Department of Pediatric Nephrology, Assistance Publique Hôpitaux de Paris, Necker Enfant Malades, Descartes University, Paris, France;
14Reference Centre of Hereditary Renal Diseases of the Child and Adult, Assistance Publique Hôpitaux de Paris, Necker Enfants Malades, Paris, France;
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Georges Deschênes
15Division of Pediatric Nephrology, Assistance Publique Hôpitaux de Paris, Robert Debré, Sorbonne University, Paris, France;
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Gema Ariceta
16Pediatric Nephrology Service, University Hospital Vall d’Hebrón, Universidad Autonoma de Barcelona, Barcelona, Spain;
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Z. Birsin Özçakar
17Division of Pediatric Nephrology and Rheumatology, Department of Pediatrics, Ankara University Medical School, Ankara, Turkey;
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Ana Teixeira
18Pediatric Nephrology Unit, Centro Hospitalar São João, Porto, Portugal;
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Ali Duzova
19Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey;
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Jérôme Harambat
20Pediatric Nephrology Unit, Bordeaux University Hospital, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche 1219, Bordeaux, France;
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Tomáš Seeman
21Department of Pediatrics, 2nd Medical Faculty, University Hospital Motol, Charles University Prague, Prague, Czech Republic;
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Gabriela Hrčková
22Department of Pediatrics of the Faculty of Medicine, Comenius University in Bratislava and the University Children’s Hospital Bratislava, Bratislava, Slovakia;
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Adrian Catalin Lungu
23Pediatric Nephrology Department, Fundeni Clinical Institute, Bucharest, Romania;
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Svetlana Papizh
5Department of Inherited and Acquired Kidney Diseases, Research and Clinical Institute for Pediatrics, Pirogov Russian National Research Medical University, Moscow, Russia;
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Amira Peco-Antic
24Nephrology Department, University Children's Hospital and School of Medicine, University of Belgrade, Serbia;
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Stéphanie De Rechter
2Polycystic Kidney Disease Research Group, Laboratory of Pediatrics, Department of Development and Regeneration, Gynaecology Pediatrics and Urology (G-PURE), Katholieke Universiteit Leuven, Leuven, Belgium;
3Department of Pediatric Nephrology, University Hospitals Leuven, Leuven, Belgium;
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Ugo Giordano
25Arterial Hypertension Unit, Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy;
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Marietta Kirchner
26Department of Medical Biometry, Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany;
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Teresa Lutz
27Pediatric Nephrology Division, Center for Pediatrics and Adolescent Medicine, Heidelberg University Hospital, Heidelberg, Germany;
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Franz Schaefer
27Pediatric Nephrology Division, Center for Pediatrics and Adolescent Medicine, Heidelberg University Hospital, Heidelberg, Germany;
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Olivier Devuyst
28Institute of Physiology, University of Zurich, Zurich, Switzerland; and
29Division of Nephrology, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium
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Elke Wühl
27Pediatric Nephrology Division, Center for Pediatrics and Adolescent Medicine, Heidelberg University Hospital, Heidelberg, Germany;
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Francesco Emma
1Division of Nephrology, Department of Pediatric Subspecialties, and
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Abstract

Background and objectives Autosomal dominant polycystic kidney disease is the most common inheritable kidney disease, frequently thought to become symptomatic in adulthood. However, patients with autosomal dominant polycystic kidney disease may develop signs or symptoms during childhood, in particular hypertension. Although ambulatory BP monitoring is the preferred method to diagnose hypertension in pediatrics, data in children with autosomal dominant polycystic kidney disease are limited.

Design, setting, participants, & measurements Our retrospective multicenter study was conducted to collect ambulatory BP monitoring recordings from patients with autosomal dominant polycystic kidney disease age <18 years old. Basic anthropometric parameters as well as data on kidney function, BP treatment, and kidney ultrasound were also collected.

Results Data from 310 children with autosomal dominant polycystic kidney disease with a mean age of 11.5±4.1 years old were collected at 22 European centers. At the time when ambulatory BP monitoring was performed, 95% of children had normal kidney function. Reference data for ambulatory BP monitoring were available for 292 patients. The prevalence rates of children with hypertension and/or those who were treated with antihypertensive drugs were 31%, 42%, and 35% during daytime, nighttime, or the entire 24-hour cycle, respectively. In addition, 52% of participants lacked a physiologic nocturnal BP dipping, and 18% had isolated nocturnal hypertension. Logistic regression analysis showed a significant association between a categorical cyst score that was calculated on the basis of the number of cysts >1 cm per kidney and daytime hypertension (odds ratio, 1.70; 95% confidence interval, 1.21 to 2.4; P=0.002), nighttime hypertension (odds ratio, 1.31; 95% confidence interval, 1.05 to 1.63; P=0.02), or 24-hour hypertension (odds ratio, 1.39; 95% confidence interval, 1.08 to 1.81; P=0.01). Kidney length, expressed as SD score, was also significantly associated with nighttime hypertension (odds ratio, 1.23; 95% confidence interval, 1.06 to 1.42; P=0.10).

Conclusions These data indicate high prevalence of hypertension in children with autosomal dominant polycystic kidney disease starting at young ages.

  • ABPM
  • Ambulatory Blood Pressure Monitoring
  • Antihypertensive Agents
  • Autosomal Dominant Polycystic Kidney Disease
  • blood pressure
  • Blood Pressure Determination
  • Blood Pressure Monitoring, Ambulatory
  • Child
  • Cysts
  • Humans
  • hypertension
  • kidney
  • Logistic Models
  • pediatrics
  • Polycystic Kidney, Autosomal Dominant
  • Prevalence
  • Retrospective Studies
  • Rhythm Analysis
  • Received October 11, 2017.
  • Accepted February 27, 2018.
  • Copyright © 2018 by the American Society of Nephrology
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Clinical Journal of the American Society of Nephrology: 13 (6)
Clinical Journal of the American Society of Nephrology
Vol. 13, Issue 6
June 07, 2018
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Prevalence of Hypertension in Children with Early-Stage ADPKD
Laura Massella, Djalila Mekahli, Dušan Paripović, Larisa Prikhodina, Nathalie Godefroid, Anna Niemirska, Ayşe Ağbaş, Karolina Kalicka, Augustina Jankauskiene, Malgorzata Mizerska-Wasiak, Alberto Caldas Afonso, Rémi Salomon, Georges Deschênes, Gema Ariceta, Z. Birsin Özçakar, Ana Teixeira, Ali Duzova, Jérôme Harambat, Tomáš Seeman, Gabriela Hrčková, Adrian Catalin Lungu, Svetlana Papizh, Amira Peco-Antic, Stéphanie De Rechter, Ugo Giordano, Marietta Kirchner, Teresa Lutz, Franz Schaefer, Olivier Devuyst, Elke Wühl, Francesco Emma
CJASN Jun 2018, 13 (6) 874-883; DOI: 10.2215/CJN.11401017

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Prevalence of Hypertension in Children with Early-Stage ADPKD
Laura Massella, Djalila Mekahli, Dušan Paripović, Larisa Prikhodina, Nathalie Godefroid, Anna Niemirska, Ayşe Ağbaş, Karolina Kalicka, Augustina Jankauskiene, Malgorzata Mizerska-Wasiak, Alberto Caldas Afonso, Rémi Salomon, Georges Deschênes, Gema Ariceta, Z. Birsin Özçakar, Ana Teixeira, Ali Duzova, Jérôme Harambat, Tomáš Seeman, Gabriela Hrčková, Adrian Catalin Lungu, Svetlana Papizh, Amira Peco-Antic, Stéphanie De Rechter, Ugo Giordano, Marietta Kirchner, Teresa Lutz, Franz Schaefer, Olivier Devuyst, Elke Wühl, Francesco Emma
CJASN Jun 2018, 13 (6) 874-883; DOI: 10.2215/CJN.11401017
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Keywords

  • ABPM
  • ambulatory blood pressure monitoring
  • antihypertensive agents
  • autosomal dominant polycystic kidney disease
  • blood pressure
  • Blood Pressure Determination
  • Blood Pressure Monitoring, Ambulatory
  • child
  • Cysts
  • humans
  • hypertension
  • kidney
  • Logistic Models
  • pediatrics
  • Polycystic Kidney, Autosomal Dominant
  • prevalence
  • Retrospective Studies
  • Rhythm Analysis

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