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BP control and left ventricular hypertrophy regression in children with CKD
Juan C Kupferman1, Lisa Aronson Friedman, Christopher Cox
1Division of Pediatric Nephrology and Hypertension, Maimonides Medical Center, Brooklyn, New York;
Journal of the American Society of Nephrology : JASN
|September 28, 2013
Summary
In children with chronic kidney disease (CKD), high blood pressure (BP) is linked to left ventricular hypertrophy. Lowering BP may reduce this heart condition in pediatric CKD patients.
Area of Science:
- Pediatric Nephrology
- Cardiology
- Clinical Research
Background:
- Hypertension is a known risk factor for left ventricular hypertrophy in adults with chronic kidney disease (CKD).
- The association between blood pressure (BP) and left ventricular hypertrophy in pediatric CKD patients remains unclear.
Purpose of the Study:
- To investigate the relationship between blood pressure and left ventricular hypertrophy in children with CKD.
- To identify predictors of left ventricular hypertrophy in this population.
Main Methods:
- Prospective analysis of data from the Chronic Kidney Disease in Children cohort.
- Utilized linear mixed models and mixed logistic models, adjusted for informative dropout using a joint longitudinal and survival model.
- Measured BP annually and echocardiograms at baseline and every two years.
Main Results:
- Systolic BP, anemia, and certain antihypertensive medications predicted left ventricular mass index.
- Systolic BP, female sex, anemia, and other antihypertensive medications predicted left ventricular hypertrophy.
- Adjusted prevalence of left ventricular hypertrophy decreased from 15.3% to 12.6% over 4 years in systolic BP models.
Conclusions:
- A decline in blood pressure may predict a reduction in left ventricular hypertrophy in children with CKD.
- Anemia and specific antihypertensive medication use are also significant factors in pediatric CKD patients.
- Further investigation into predictors of left ventricular hypertrophy in this cohort is warranted.
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