title: Hypertension in dialysed children: the prevalence and therapeutic approach in Poland--a nationwide survey.
abstract: BACKGROUND
  The aim of this nationwide analysis was to assess the incidence and current treatment profile of arterial hypertension in children undergoing chronic haemodialysis or peritoneal dialysis and attitudes of paediatric nephrologists towards the choice of antihypertensive drugs in their patients.
  
  
  METHODS
  The study group consisted of 134 children (89 males, 45 females, mean age 10.7+/-5 years) from all 13 paediatric dialysis centres in Poland. The data were gathered through a questionnaire for each patient dialysed in November 2004.
  
  
  RESULTS
  The overall incidence of hypertension in the study group was 55% (74 of 134 patients; 47 males, 27 females). The incidence rate was similar in boys and girls (53 vs 60%) and in those on haemodialysis and peritoneal dialysis (56 vs 54%). Chronic glomerulonephritis as an underlying renal disease was significantly more frequent in the hypertensive than in the normotensive subjects (37 vs 10%, P = 0.004). Residual urine output was higher in normotensives (41 vs 10 ml/kg body weight; P < 0.001). Among those treated with antihypertensives: 32% were treated by monotherapy, 36% received two drugs, 22% received three drugs, while 7% received > or = 4 drugs. The therapy was effective in only 57% of subjects. We observed no differences in biochemical and clinical parameters between those who responded to the therapy and those who failed to do so. Calcium channel blockers constituted the most frequently administered class of drugs [73% of children; in 43 out of 48 (90%) combined with other drugs, but in 11 out of 24 (46%) as a monotherapy]. In monotherapy, angiotensin-converting enzyme inhibitors and calcium channel blockers were administered most frequently.
  
  
  CONCLUSIONS
  We conclude that the incidence of hypertension in dialysis children in Poland is high (55%). The effectiveness of antihypertensive treatment is rather low (58%) and the choice of drugs is limited.
authors.affiliation: Department of Nephrology and Dialysis, Polish Mother's Memorial Hospital Research Institute of Łódź, Poland. mtkaczyk@uni.lodz.pl
authors.forename: Marcin
authors.initials: M
authors.lastname: Tkaczyk
authors.forename: Michał
authors.initials: M
authors.lastname: Nowicki
authors.forename: Irena
authors.initials: I
authors.lastname: Bałasz-Chmielewska
authors.forename: Hanna
authors.initials: H
authors.lastname: Boguszewska-Baçzkowska
authors.forename: Dorota
authors.initials: D
authors.lastname: Drozdz
authors.forename: Barbara
authors.initials: B
authors.lastname: Kołłataj
authors.forename: Tomasz
authors.initials: T
authors.lastname: Jarmoliński
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Jobs
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Kiliś-Pstrusińska
authors.forename: Beata
authors.initials: B
authors.lastname: Leszczyńska
authors.forename: Irena
authors.initials: I
authors.lastname: Makulska
authors.forename: Dariusz
authors.initials: D
authors.lastname: Runowski
authors.forename: Roman
authors.initials: R
authors.lastname: Stankiewicz
authors.forename: Maria
authors.initials: M
authors.lastname: Szczepańska
authors.forename: Ryszard
authors.initials: R
authors.lastname: Wierciński
authors.forename: Ryszard
authors.initials: R
authors.lastname: Grenda
authors.forename: Andrzej
authors.initials: A
authors.lastname: Kanik
authors.forename: Jacek A
authors.initials: JA
authors.lastname: Pietrzyk
authors.forename: Maria
authors.initials: M
authors.lastname: Roszkowska-Blaim
authors.forename: Krystyna
authors.initials: K
authors.lastname: Szprynger
authors.forename: Jacek
authors.initials: J
authors.lastname: Zachwieja
authors.forename: Maria M
authors.initials: MM
authors.lastname: Zajaczkowska
authors.forename: Walentyna
authors.initials: W
authors.lastname: Zoch-Zwierz
authors.forename: Danuta
authors.initials: D
authors.lastname: Zwolińska
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Zurowska
mesh_terms: D000293:Adolescent; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D011044:Poland / Q000453:epidemiology; D011159:Population Surveillance; D015995:Prevalence; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
chemical_list: D000959:Antihypertensive Agents