Kidney Week

Abstract: FR-PO385

Risk of Target-Organ Damage in Pediatric Patients with CKD and Ambulatory Hypertension: A Systematic Review and Meta-Analysis

Session Information

• Hypertension, CVD, and the Kidneys: Epidemiology
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1602 Hypertension and CVD: Clinical

Authors

• Yu, Andrew, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada

Andrew Yu

• Chung, Jason, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada

Jason Chung, MD

• Robinson, Cal, The Hospital for Sick Children, Toronto, Ontario, Canada

Cal Robinson, MBChB

• Dionne, Janis M., BC Children's Hospital, Vancouver, British Columbia, Canada

Janis M. Dionne, MD

• Parekh, Rulan S., Women's College Hospital, Toronto, Ontario, Canada

Rulan S. Parekh, MD, MS, FASN

• South, Andrew M., Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States

Andrew M. South, MD, MS

• Mitsnefes, Mark, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States

Mark Mitsnefes, MD, MS

• Noone, Damien Gerard, The Hospital for Sick Children, Toronto, Ontario, Canada

Damien Gerard Noone, MD

• Chanchlani, Rahul, McMaster Children's Hospital, Hamilton, Ontario, Canada

Rahul Chanchlani, MD, MBBS, MS, FASN

Background

The objective of this systematic review is to determine the association of ambulatory hypertension and various ambulatory blood pressure monitoring (ABPM) parameters with left ventricular mass index (LVMI) in youth with CKD.

Methods

A systematic literature search on nine databases included English publications from 1974-2022. LVMI was indexed to subject height and body surface area (g/m^2.7). Correlation coefficients were transformed and pooled using a random effects model. All stages of CKD were included for this review. Normative values of ABPM were derived from the German Working Group on Pediatric Hypertension.

Results

Of 1,128 screened studies, 16 studies and 2,254 children and adolescents were included. LVMI was elevated in the CKD hypertensive group compared to the CKD normotensive group (mean difference: 6.22 g/m^2.7, 95% CI: 4.80-7.65). Youth with hypertension were at 3.34 (95% CI: 2.38-4.68) higher odds of left ventricular hypertrophy compared to normotensive children.

Conclusion

Pediatric CKD patients with ambulatory hypertension especially during nighttime were more likely to have higher LVMI and left ventricular hypertrophy. Adequate blood pressure control among children with CKD may be crucial to avoid the risk of target organ damage and future cardiovascular disease.