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Plasma renin and occurrence of hypertension in children with burn injuries
Insights
Children experiencing severe burns often develop hypertension. This study found high plasma renin levels in hypertensive children, suggesting renin activity may predict hypertension after thermal injury.
Area of Science:
- Pediatric critical care medicine
- Renal physiology
- Cardiovascular research
Background:
- Children with thermal injuries exhibit a high incidence of postinjury hypertension.
- The role of the renin-angiotensin system in this hypertension is not fully understood.
Purpose of the Study:
- To investigate the activity of the renin-angiotensin system in children following thermal injuries.
- To determine if renin levels can predict the development of hypertension in pediatric burn patients.
Main Methods:
- Plasma renin levels were measured in children during their postinjury care.
- Patients were monitored for the development of hypertension.
- Correlation between renin levels and blood pressure was analyzed.
Main Results:
- Sustained hypertension occurred in 3 of 11 children.
- Markedly elevated plasma renin levels (greater than 2IRU x 10(4)) were observed in all hypertensive children.
- Abnormally high plasma renin was also seen in 2 of 5 children with hypertensive episodes.
- No normotensive patients had markedly elevated renin levels.
Conclusions:
- Markedly elevated plasma renin levels may be predictive of hypertension in children with thermal injuries.
- Elevated renin secretion may be influenced by regional blood flow and catecholamine activity.
Abstract:
Children with thermal injuries have an unusually high incidence of hypertension during the course of their postinjury care. This study investigates the activity of the renin angiotensin system during the postinjury period. Sustained hypertension occurred in three of 11 children studied. All three cases demonstrated markedly elevated plasma renin levels (greater than 2IRU x 10(4)). Two of five children with episodes of hypertension also demonstrated abnormally high plasma renin. No normotensive patients had markedly elevated renin levels. The mechanism directing elevated renin secretion may be related to changes in regional blood flow in addition to the stimulus of increased catecholamine activity. A markedly elevated plasma renin may be predictive of the development of hypertension.