title: Demographics of blood pressure and hypertension in children on renal replacement therapy in Europe.
abstract: Hypertension is a well-known complication in children on renal replacement therapy and an important risk factor for cardiovascular disease in later life. In order to define the prevalence of and risk factors for hypertension among children, we enrolled 3337 pediatric patients from 15 countries in the ESPN/ERA-EDTA Registry of whom 464 were on hemodialysis, 851 on peritoneal dialysis, and 2023 had received a renal allograft. Hypertension was defined as either systolic or diastolic blood pressures in the 95th percentile or greater for age, height, and gender or use of antihypertensive medication. Analyses were adjusted for age, gender, duration, and modality of renal replacement therapy. In 10 countries in which information on the use of antihypertensive medication was available, hypertension was present in over two-thirds of hemodialysis, peritoneal dialysis, or transplant patients. Blood pressure values above the 95th percentile were significantly more prevalent in very young patients (under 3 years) compared to 13- to 17-year olds (odds ratio 2.47), during the first year compared to over 5 years of renal replacement therapy (odds ratio 1.80), and in patients on hemodialysis compared to transplant recipients or those on peritoneal dialysis (odds ratios of 2.48 and 1.59, respectively). Over time, mean blood pressures decreased in both hemodialysis and transplant patients, but not in peritoneal dialysis patients. Hence, our findings highlight the extent of the problem of hypertension in children with end-stage renal disease in Europe.
authors.affiliation: ESPN/ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: A Marijn
authors.initials: AM
authors.lastname: Kramer
authors.forename: Karlijn J
authors.initials: KJ
authors.lastname: van Stralen
authors.forename: Kitty J
authors.initials: KJ
authors.lastname: Jager
authors.forename: Franz
authors.initials: F
authors.lastname: Schaefer
authors.forename: Enrico
authors.initials: E
authors.lastname: Verrina
authors.forename: Tomáš
authors.initials: T
authors.lastname: Seeman
authors.forename: Malcolm A
authors.initials: MA
authors.lastname: Lewis
authors.forename: Michael
authors.initials: M
authors.lastname: Boehm
authors.forename: Giacomo D
authors.initials: GD
authors.lastname: Simonetti
authors.forename: Gregor
authors.initials: G
authors.lastname: Novljan
authors.forename: Jaap W
authors.initials: JW
authors.lastname: Groothoff
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005060:Europe; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology*; D007223:Infant; D007231:Infant, Newborn; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D016030:Kidney Transplantation / Q000009:adverse effects; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D010530:Peritoneal Dialysis / Q000009:adverse effects; D015995:Prevalence; D012042:Registries; D006435:Renal Dialysis / Q000009:adverse effects; D017582:Renal Replacement Therapy / Q000009:adverse effects*; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
chemical_list: D000959:Antihypertensive Agents