title: Hypertension and left ventricular hypertrophy in pediatric peritoneal dialysis patients: ambulatory blood pressure monitoring and echocardiographic evaluation.
abstract: BACKGROUND
  Hypertension is a frequent complication of end-stage renal disease and left ventricular hypertrophy (LVH) is common in patients with poorly controlled hypertension. The aim of this study was to evaluate hypertension in pediatric peritoneal dialysis (PD) patients, to compare casual and ambulatory blood pressure (BP) measurements and to evaluate the impact of BP parameters on LVH.
  
  
  METHODS
  The study comprised 25 PD patients (9 M, 16 F; mean age 14.14 +/- 3.32 years) that have been followed in outpatient clinics. Medical records were reviewed for demographic features; casual BP measurements, ambulatory blood pressure monitoring (ABPM) and echocardiographic evaluation were applied to all patients.
  
  
  RESULTS
  The mean 24-hour and daytime systolic blood pressure (SBP) values were found to be higher than casual SBP (p < 0.001). Significant difference was present in the frequency of hypertension between casual SBP (32%) and the mean daytime SBP (56%) (p < 0.05). Nighttime systolic hypertension was detected in 14 (56%) and diastolic hypertension in 16 (64%) patients. Elevated daytime SBP load and DBP load were detected in 64 and 76% of the patients, respectively. Elevated nighttime SBP load and DBP load were detected in 72% of the patients. Seventeen (68%) patients had attenuated dipping for SBP. The mean left ventricular mass index (LVMI) was 52.65 +/- 18.17 g/m(2.7) and 13 (52%) patients had LVH. LVMI was significantly correlated with casual BP measurements and the majority of ABPM parameters.
  
  
  CONCLUSIONS
  The majority of pediatric PD patients had BP abnormalities in which severity was most accurately assessed with ABPM. Casual BP and majority of ABPM parameters were found to be significantly correlated with LVMI. Ambulatory blood pressure monitoring should be performed in all pediatric PD patients.
authors.affiliation: Department of Pediatric Nephrology, Ankara University School of Medicine, Ankara, Turkey. zbozcakar@yahoo.com
authors.forename: Z Birsin
authors.initials: ZB
authors.lastname: Ozçakar
authors.forename: Fatoş
authors.initials: F
authors.lastname: Yalçinkaya
authors.forename: Ercan
authors.initials: E
authors.lastname: Tutar
authors.forename: Nilgün
authors.initials: N
authors.lastname: Cakar
authors.forename: Tayfun
authors.initials: T
authors.lastname: Uçar
authors.forename: Atilla
authors.initials: A
authors.lastname: Elhan
authors.forename: Banu
authors.initials: B
authors.lastname: Acar
authors.forename: Selçuk
authors.initials: S
authors.lastname: Yüksel
authors.forename: Nermin
authors.initials: N
authors.lastname: Uncu
authors.forename: Nazli
authors.initials: N
authors.lastname: Kara
authors.forename: Semra
authors.initials: S
authors.lastname: Atalay
authors.forename: Mesiha
authors.initials: M
authors.lastname: Ekim
mesh_terms: D000293:Adolescent; D001795:Blood Pressure Determination / Q000379:methods*; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D006977:Hypertension, Renal / Q000175:diagnosis* / Q000209:etiology; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis* / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D008297:Male; D018670:Monitoring, Ambulatory / Q000379:methods*; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D016896:Treatment Outcome