Hypertension in dialysed children: the prevalence and therapeutic approach in Poland--a nationwide survey.
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.
Tkaczyk
Marcin
M
Department of Nephrology and Dialysis, Polish Mother's Memorial Hospital Research Institute of Łódź, Poland. mtkaczyk@uni.lodz.pl
Nowicki
Michał
M
Bałasz-Chmielewska
Irena
I
Boguszewska-Baçzkowska
Hanna
H
Drozdz
Dorota
D
Kołłataj
Barbara
B
Jarmoliński
Tomasz
T
Jobs
Katarzyna
K
Kiliś-Pstrusińska
Katarzyna
K
Leszczyńska
Beata
B
Makulska
Irena
I
Runowski
Dariusz
D
Stankiewicz
Roman
R
Szczepańska
Maria
M
Wierciński
Ryszard
R
Grenda
Ryszard
R
Kanik
Andrzej
A
Pietrzyk
Jacek A
JA
Roszkowska-Blaim
Maria
M
Szprynger
Krystyna
K
Zachwieja
Jacek
J
Zajaczkowska
Maria M
MM
Zoch-Zwierz
Walentyna
W
Zwolińska
Danuta
D
Zurowska
Aleksandra
A
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
D000959:Antihypertensive Agents