title: Can renal leukemic infiltration cause hypertension in children?
abstract: Out of 334 children with acute lymphoblastic leukemia who were treated with St Jude Total XI and Total XIII chemotherapy protocols were investigated and 21 (6.3%) were hypertensive. The incidence of tumor lysis syndrome was higher in the hypertensive group than in the nonhypertensive group (28.6% vs. 11.5%) (P = 0.035). There were no differences between patients treated with high-dose methylprednisolone and prednisolone St Jude Total XI and Total XIII, St Jude Total XIII LR and St Jude Total XIII HR groups in respect of the above-mentioned parameters. Central nervous system involvement, skeletal system involvement, abdominal lymphadenopathy, elevated lactate dehydrogenase and leukocyte count, French-American-British types and immunophenotypes were not found to be statistically significant to the development of hypertension (P > 0.05). We found that renal leukemic infiltration is a risk factor in hypertension development (P = 0.04) and hypertension is a risk factor for renal parenchymal disorder in the follow-up period (P = 0.0001). Six patients presenting with hypertension in the first week of disease therapy were evaluated for renal parenchymal disorder and glomerular filtration rate abnormality in the follow-up period. Glomerular filtration rate abnormality was found in 1 and renal scintigraphic dimercaptosuccinic acid abnormalities (reduced uptake and dilated hypoactivity) were found in 4 patients. Hypertension was also found to be a risk factor for renal parenchymal disorder in the follow-up period.
authors.affiliation: Department of Pediatric Hematology, Faculty of Medicine, Hacettepe University, Ankara 06100, Turkey.
authors.forename: Seref
authors.initials: S
authors.lastname: Olgar
authors.forename: Sevgi
authors.initials: S
authors.lastname: Yetgin
authors.forename: Mualla
authors.initials: M
authors.lastname: Cetin
authors.forename: Tulin
authors.initials: T
authors.lastname: Aras
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006977:Hypertension, Renal / Q000209:etiology*; D007668:Kidney / Q000473:pathology*; D007677:Kidney Function Tests; D017254:Leukemic Infiltration / Q000150:complications*; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors