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Hypertension/prehypertension and its determinants in pediatric IgA nephropathy

Qing-Ying Fu1, Lu Ma, Chang-Chun Li

  • 1Integrated Chinese and Western Medicine Treatment of Renal Disease Center, Beidaihe Rehabilitation and Recuperation Center, Chinese PLA, Qinhuangdao, China.

Medicine
|October 6, 2020
PubMed

Insights

Hypertension/prehypertension in pediatric IgA nephropathy (IgAN) is linked to poorer outcomes and less remission. Management of blood pressure, active lesions, and coagulation may slow disease progression in these children.

Area of Science:

  • Nephrology
  • Pediatric Nephrology
  • Hypertension Research

Background:

  • Immunoglobulin A nephropathy (IgAN) is a leading cause of secondary renal hypertension (HT).
  • Prehypertension (pre-HT) is a growing concern in children, but its impact on pediatric IgAN progression is unknown.
  • Understanding the role of HT/pre-HT in pediatric IgAN is crucial for identifying therapeutic targets.

Purpose of the Study:

  • To investigate the effects of HT/pre-HT on the prognosis of pediatric IgAN.
  • To identify determinants of HT/pre-HT and their correlation with clinicopathological parameters.
  • To explore potential therapeutic strategies for IgAN with HT/pre-HT.

Main Methods:

  • A single-center retrospective study of 108 children with IgAN.
  • Comparison of clinicopathological features and outcomes between patients with and without HT/pre-HT.
  • Evaluation of independent risk factors for HT/pre-HT and their association with histological findings.

Main Results:

  • Patients with HT/pre-HT had significantly worse clinical outcomes and lower rates of complete remission (P=.014).
  • Independent risk factors for HT/pre-HT included age, serum creatinine, prothrombin time, and segmental glomerulosclerosis (P<.05).
  • Segmental glomerulosclerosis strongly correlated with glomerular crescents, Lees grades, arteriolar thickening, and endocapillary hypercellularity.

Conclusions:

  • HT/pre-HT is a significant, modifiable factor influencing pediatric IgAN prognosis.
  • Segmental glomerulosclerosis is a key determinant of HT/pre-HT in this population.
  • Therapeutic strategies targeting coagulation, active lesions, and hemodynamics may improve outcomes for pediatric IgAN patients with HT/pre-HT.

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