title: Prediction of primary vs secondary hypertension in children.
abstract: Despite current guidelines, variability exists in the workup of hypertensive children due to physician preferences. The study evaluates primary vs secondary hypertension diagnosis from investigations routinely performed in hypertensive children. This retrospective study included children 5 to 19 years with primary and secondary hypertension. The proportions of abnormal laboratory and imaging tests were compared between primary and secondary hypertension groups. Risk factors for primary vs secondary hypertension were evaluated by logistic regression and likelihood function analysis. Patients with secondary hypertension were younger (5-12 years) and had a higher proportion of abnormal creatinine, renal ultrasound, and echocardiogram findings. There was no significant difference in abnormal results of thyroid function, urine catecholamines, plasma renin, and aldosterone. Abnormal renal ultrasound findings and age were predictors of secondary hypertension by regression and likelihood function analysis. Children aged 5 to 12 years with abnormal renal ultrasound findings and high diastolic blood pressures are at higher risk for secondary hypertension that requires detailed evaluation.
authors.affiliation: Department of Pediatric Nephrology, Children's Hospital of Michigan, Wayne State University, Detroit, MI 48201, USA.
authors.forename: Rossana
authors.initials: R
authors.lastname: Baracco
authors.forename: Gaurav
authors.initials: G
authors.lastname: Kapur
authors.forename: Tej
authors.initials: T
authors.lastname: Mattoo
authors.forename: Amrish
authors.initials: A
authors.lastname: Jain
authors.forename: Rudolph
authors.initials: R
authors.lastname: Valentini
authors.forename: Maheen
authors.initials: M
authors.lastname: Ahmed
authors.forename: Ronald
authors.initials: R
authors.lastname: Thomas
mesh_terms: D000293:Adolescent; D000450:Aldosterone / Q000097:blood; D015415:Biomarkers / Q000378:metabolism; D002395:Catecholamines / Q000652:urine; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D006978:Hypertension, Renovascular / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D007668:Kidney / Q000000981:diagnostic imaging; D007674:Kidney Diseases / Q000150:complications*; D008297:Male; D009765:Obesity / Q000150:complications*; D011237:Predictive Value of Tests; D012083:Renin / Q000097:blood; D012189:Retrospective Studies; D012307:Risk Factors; D013961:Thyroid Gland / Q000503:physiopathology; D055815:Young Adult
chemical_list: D015415:Biomarkers; D002395:Catecholamines; D000450:Aldosterone; D003404:Creatinine; D012083:Renin