Hypertension affected 60.7% of children and adolescents on kidney replacement therapy, though uncontrolled hypertension decreased significantly over 5 years in hemodialysis and transplant patients.
Observational (n=6,071)
Yes
Hypertension is highly prevalent in pediatric patients on kidney replacement therapy, particularly those on hemodialysis, but uncontrolled hypertension was not associated with increased short-term all-cause mortality.
Effect estimate: aHR 1.02 (95% CI 0.79-1.33)
Abstract Background Hypertension (HTN) is a well-known complication among patients on pediatric kidney replacement therapy (KRT). We aimed to evaluate demographics, longitudinal changes and outcomes of high blood pressure (BP) among children and adolescents on KRT. Methods Data on BP and antihypertensive (AH) medications reported to the ESPN/ERA Registry on 6071 patients from 28 European countries starting KRT 95th percentile. Uncontrolled HTN significantly decreased over time in HD patients (52.3% at dialysis start vs. 42.5% after 5 years; annual percentage change APC − 3.5%; 95%CI: − 6.2; -0.7), despite similar AH medication use. After 5 years, transplanted patients showed a significant reduction in both prevalence of uncontrolled HTN (APC − 3.6%; 95%CI: − 5.7; − 1.5) and AH medication use (APC − 1.6%; 95%CI: − 2.6; − 0.6%). No trends were found for PD patients. Uncontrolled HTN was not associated with mortality (aHR 1.02; 95%CI: 0.79–1.33). Conclusions HTN is highly prevalent in children and adolescents on KRT. Younger children and HD patients should be carefully evaluated for BP status after entering dialysis or shortly after transplantation. Graphical abstract
Vidal et al. (Wed,) conducted a observational in Kidney replacement therapy in children and adolescents (n=6,071). Kidney replacement therapy (Hemodialysis, Peritoneal Dialysis, Transplantation) was evaluated on All-cause mortality associated with uncontrolled hypertension (aHR 1.02, 95% CI 0.79-1.33). Hypertension affected 60.7% of children and adolescents on kidney replacement therapy, though uncontrolled hypertension decreased significantly over 5 years in hemodialysis and transplant patients.