Increased blood pressure in adult offspring of families with Balkan endemic nephropathy: a prospective study.
BACKGROUND
Previous studies have linked smaller kidney dimensions to increased blood pressure. However, patients with Balkan Endemic Nephropathy (BEN), whose kidneys shrink during the course of the disease, do not manifest increased blood pressure. The authors evaluated the relationship between kidney cortex width, kidney length, and blood pressure in the offspring of BEN patients and controls.


METHODS
102 offspring of BEN patients and 99 control offspring of non-BEN hospital patients in the Vratza District, Bulgaria, were enrolled in a prospective study and examined twice (2003/04 and 2004/05). Kidney dimensions were determined using ultrasound, blood pressure was measured, and medical information was collected. The parental disease of BEN was categorized into three groups: mother, father, or both parents. Repeated measurements were analyzed with mixed regression models.


RESULTS
In all participants, a decrease in minimal kidney cortex width of 1 mm was related to an increase in systolic blood pressure of 1.4 mm Hg (p = 0.005). There was no association between kidney length and blood pressure. A maternal history of BEN was associated with an increase in systolic blood pressure of 6.7 mm Hg (p = 0.03); paternal BEN, +3.2 mm Hg (p = 0.35); or both parents affected, +9.9 mm Hg (p = 0.002). There was a similar relation of kidney cortex width and parental history of BEN with pulse pressure; however, no association with diastolic blood pressure was found.


CONCLUSIONS
In BEN and control offspring, a smaller kidney cortex width predisposed to higher blood pressure. Unexpectedly, a maternal history of BEN was associated with average increased systolic blood pressure in offspring.
Dimitrov
Plamen S
PS
National Center of Public Health Protection, 15 Acad. Ivan Geshov Street, Sofia, Bulgaria. p.dimitrov@ncphp.government.bg
Simeonov
Valeri A
VA
Tsolova
Svetlana D
SD
Bonev
Angel G
AG
Georgieva
Rossitza B
RB
Karmaus
Wilfried J
WJ
D000328:Adult; D032721:Adult Children; D001449:Balkan Nephropathy / Q000235:genetics* / Q000473:pathology / Q000503:physiopathology*; D001794:Blood Pressure / Q000235:genetics; D002031:Bulgaria; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000235:genetics* / Q000473:pathology / Q000503:physiopathology*; D007672:Kidney Cortex / Q000473:pathology / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies