[Arterial hypertension in children with end-stage renal failure treated with hemodialysis]

Cardiovascular disorders contribute in increased morbidity and mortality of patients with chronic renal failure. Uncontrolled, long-term arterial hypertension is noted as a major risk factor. The study aimed at evaluation of arterial hypertension incidence and efficiency of its treatment among patients on maintenance hemodialysis (HD).

The study included 24 children and young adults with chronic renal failure on hemodialysis treatment, for the period longer than 6 months, in the 1997-2002 years. Patients data were retrospectively analyzed in 3-month's intervals. At the beginning of follow-up systolic and diastolic arterial hypertension (values exceeding 95 percentile value for age and height) before dialysis session was revealed respectively in 58% and 46% of children, and after dialysis session the occurrence of both systolic and diastolic hypertension was 42%.

After 33 months of treatment the incidence of predialysis systolic and diastolic hypertension was respectively 15.5% and 8% and postdialysis both systolic and diastolic hypertension - 23%. Ejection fraction (EF) increased almost significantly after 18 months of treatment with hemodialysis, but after 30 months EF reached baseline value. Cardiac contractility was nonsignificantly improved after 18 months of treatment, and after 30 months declined to baseline value. 62.5% of children in examined group were treated with more than one antihypertensive drug.

We found that the amount of antihypertensive drugs correlated with values of systolic and diastolic blood pressure till 18 month of follow-up as well as in 30 month of observation.